tag:blogger.com,1999:blog-41192376723839308482015-03-03T01:22:15.963-05:00Healthy Minds. Healthy Lives.The Healthy Minds Healthy Lives blog provides information about mental health.American Psychiatric Association noreply@blogger.comBlogger169125tag:blogger.com,1999:blog-4119237672383930848.post-91506823605642052392015-02-27T11:48:00.002-05:002015-02-27T14:10:24.526-05:00Black History Month – African Americans and Mental Health<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: 14pt;">Ranna
Parekh, MD, MPH</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">As we celebrate Black
History Month, we reflect on African Americans’ place in US history. At the
APA, we give thanks to psychiatrists – such as Jeanne Spurlock, MD, Solomon
Carter Fuller, MD, Chester Pierce, MD, and a long list of <a href="http://www.americanpsychiatricfoundation.org/what-we-do/awards/diversity-awards/solomon-carter-fuller-award-for-african-american-pioneers">Solomon
Carter Fuller Award</a> recipients--whose great contributions continue to
influence our medical field.&nbsp; It is also
a time when we are reminded of the unique mental health challenges facing the
black community and the importance in working together toward improved access,
assessment and treatment. &nbsp;</span><br />
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<a href="http://3.bp.blogspot.com/-xDn1HKgd5dM/VPCZv7UN4vI/AAAAAAAACEY/RpVJ0GXDCgA/s1600/African%2BAmerican%2Bmilitary%2Bfamily.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><span style="font-family: Arial, Helvetica, sans-serif;"><img border="0" src="http://3.bp.blogspot.com/-xDn1HKgd5dM/VPCZv7UN4vI/AAAAAAAACEY/RpVJ0GXDCgA/s1600/African%2BAmerican%2Bmilitary%2Bfamily.jpg" height="138" width="200" /></span></a><span style="font-family: Arial, Helvetica, sans-serif;"> The history of African
Americans predates slavery; however, its legacy and the ongoing discrimination
continue to impact the lives of African Americans today. Emotional strength, strong social connections, and
determination have enabled many African Americans to overcome adversity.
&nbsp;Yet African Americans, just like people of all racial/ethnic backgrounds,
experience mental illness.</span><o:p></o:p></div>
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<a href="https://images-blogger-opensocial.googleusercontent.com/gadgets/proxy?url=http%3A%2F%2F4.bp.blogspot.com%2F-V0oh-wrGDGE%2FVPCZqpNYB-I%2FAAAAAAAACEQ%2FSgO70IuS5BE%2Fs1600%2FAfrican%252BAmerican%252Bfamily.jpg&amp;container=blogger&amp;gadget=a&amp;rewriteMime=image%2F*" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-V0oh-wrGDGE/VPCZqpNYB-I/AAAAAAAACEQ/SgO70IuS5BE/s1600/African%2BAmerican%2Bfamily.jpg" height="200" width="134" /></a><span style="font-family: Arial, Helvetica, sans-serif;">While rates of mental
illness in African Americans are similar to those of the general population,
African Americans receive less care and poorer quality of care and often lack
access to culturally sensitive care. For many reasons, African Americans face
particular obstacles in getting help for mental health concerns. Racism,
discrimination, cost or lack of health insurance, or distrust of the health
care system may prevent some African Americans from getting the help they
deserve. Stigma about mental illness can also pose a barrier, and blacks are
much less willing than whites to use medicines for a mental illness.<o:p></o:p></span></div>
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<a href="http://3.bp.blogspot.com/-gf3viKHnG9Q/VPCbq7lenXI/AAAAAAAACEo/3jc90xeVqmc/s1600/shutterstock_231066940.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><span style="font-family: Arial, Helvetica, sans-serif;"><img border="0" src="http://3.bp.blogspot.com/-gf3viKHnG9Q/VPCbq7lenXI/AAAAAAAACEo/3jc90xeVqmc/s1600/shutterstock_231066940.jpg" height="200" width="173" /></span></a></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">Also, African Americans
sometimes express mental illness and emotional distress differently than
others.&nbsp; For example, among people with depression, blacks are more likely
than whites to complain of body aches or other physical symptoms.&nbsp;</span><br />
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<a href="http://2.bp.blogspot.com/-7FiftUDnOEA/VPCbqzkTS1I/AAAAAAAACEk/wWccXd8Rt7I/s1600/shutterstock_72328381.jpg" imageanchor="1" style="clear: right; display: inline !important; float: right; margin-bottom: 1em; margin-left: 1em; text-align: center;"><img border="0" src="http://2.bp.blogspot.com/-7FiftUDnOEA/VPCbqzkTS1I/AAAAAAAACEk/wWccXd8Rt7I/s1600/shutterstock_72328381.jpg" height="200" width="132" /></a><span style="clear: right; display: inline !important; font-family: Arial, Helvetica, sans-serif; margin-bottom: 1em; margin-left: 1em; text-align: center;"></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">Racism
and discrimination have multiple effects on mental health.&nbsp; Victims of
discrimination experience feelings of unfairness when dealing with mental
illness and those feelings make it difficult for them to do anything about it.&nbsp;
In addition, the anticipation of discrimination, the perception of being in an
environment of discrimination, or seeing others being victims can contribute to
greater ongoing stress and anxiety.&nbsp;&nbsp;<o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">Chester M. Pierce, MD, emeritus
professor of education and psychiatry at Harvard Medical School and founder of
the eponymous Division of Global Psychiatry at the Massachusetts General
Hospital is to receive APA’s 2015 Human Rights Award. His life’s work included
studying people living in extreme conditions. In 1970, he coined the term <i>microaggessions </i>to help people
understand the continuing stain of racism experienced by African Americans.
Microaggressions are brief, everyday exchanges
that send denigrating messages that are not overt discrimination – the person
may not even be aware of the denigrating action. Being continually subjected to
these microaggressions takes a toll on physical and mental health.<span class="apple-converted-space">&nbsp;</span> <o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">This is also
compounded by the economic effects—blacks have much higher unemployment and
poverty rates than whites.&nbsp; In January 2015, the unemployment rate for black
&nbsp;men over 20 was more than twice that of
white men (11.4% vs 5.2%) and the unemployment rate for black youth age 16-19
was significantly higher than white youth (30% vs 17%).&nbsp;<o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">Also, African-American men are less likely to seek help for medical problems and
mental health concerns often become secondary to any medical concerns. Physical
conditions and conditions affecting the mind are connected in many
ways--problems that first affect the mind can later increase one’s risk for
physical problems, such as diabetes, high blood pressure, or malnutrition. And
physical conditions, such as a disease or an accident, can affect the mind
(i.e., emotions, thinking, and mood).&nbsp;African Americans have a much higher
risk than white Americans for many types of chronic diseases, such as diabetes
and heart disease.<o:p></o:p></span></div>
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<a href="http://3.bp.blogspot.com/-J2jT5qnRZ78/VPCZaEi74II/AAAAAAAACEI/krWNbzcJLFA/s1600/Beyond%2Bthe%2BBeat%2Bvideo%2Bimage.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><span style="font-family: Arial, Helvetica, sans-serif;"><img border="0" src="http://3.bp.blogspot.com/-J2jT5qnRZ78/VPCZaEi74II/AAAAAAAACEI/krWNbzcJLFA/s1600/Beyond%2Bthe%2BBeat%2Bvideo%2Bimage.png" height="230" width="320" /></span></a></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">The California Mental Health Services Authority has developed a&nbsp;</span></div>
<span style="font-family: Arial, Helvetica, sans-serif;"><a href="https://vimeo.com/113517921" target="_blank"><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: &quot;Times New Roman&quot;; mso-hansi-theme-font: minor-latin;">video</span></a>&nbsp;and&nbsp;<a href="http://calmhsa.org/wp-content/uploads/2014/09/Facilitator%E2%80%99s-Guide.pdf" target="_blank"><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: &quot;Times New Roman&quot;; mso-hansi-theme-font: minor-latin;">discussion guide</span></a>&nbsp;about young black men and
mental health.&nbsp;<o:p></o:p>
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<the 10-minute="" span="" titled="" video=""><span style="font-family: Arial, Helvetica, sans-serif;"><a href="https://vimeo.com/113517921" target="_blank"><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: &quot;Times New Roman&quot;; mso-hansi-theme-font: minor-latin;">Beyond the Beat and the Lyrics --
Understanding the Impact of Stigma and Discrimination on the Mental Health
Status of Transition-Aged African American Males,"</span></a></span>&nbsp; is intended to raise
awareness and stimulate conversation.<o:p></o:p></the></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">Mental disorders are
nothing to be ashamed of. They are real medical problems, just like heart
disease or diabetes. As with these illnesses, there is help available and much
you can do to support or improve your health. Like all people with mental
illness, African Americans, do recover and go on to lead productive and
fulfilling lives.<o:p></o:p></span></div>
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<span style="font-family: Calibri, sans-serif; font-size: 11pt;">Ranna
Parekh, MD, MPH, is the director of the Division of Diversity and Health Equity
at the American Psychiatric Association<o:p></o:p></span></div>
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American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-65980164305097309452015-02-25T13:17:00.001-05:002015-02-25T13:17:34.872-05:00A Psychiatrist’s Take on “Fifty Shades”<span style="font-family: Arial, Helvetica, sans-serif;">By Kenneth Paul Rosenberg, MD</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif;">I am neither a film critic, nor a sociologist, but to me, “Fifty Shades of Grey” is neither groundbreaking cinema, nor does it herald a new cultural shift in sexual mores. It is, nonetheless, a fascinating narrative for any student of psychology, let alone for a psychiatrist with a specialty in treating sexual disorders. Hence, when asked to write about the movie, it was my pleasure to offer a few thoughts. &nbsp;&nbsp;</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif;">“Fifty Shades” is the story of Christian Grey and college-aged Anastasia Steele, whom he sweeps off her feet and into his den of bondage, whipping and domination. Christian is a concert-level classical pianist and helicopter and glider pilot. &nbsp;He is ridiculously handsome, under 30 and a billionaire. His Achilles’ heel is that he is the unfortunate victim of childhood physical and sexual abuse at the hands of older women, and, as a consequence, can only connect by inflicting sexual pain on the beautiful virgin, Anastasia.&nbsp;</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif;">For all his power and sadism, Christian is also partly a victim himself. He teaches us about the lingering effects of childhood abuse, and introduces the audience to the practices of bondage, domination, sadism and masochism (BDSM). &nbsp; Although being a “dominant” is Christian’s ‘thing,’ clinically, one would expect Christian to be a submissive who would seek out reenactments of his abuse at the hands of an older woman.&nbsp;</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif;">Ana is essentially a young woman who falls in love with an older, extremely powerful and rich man – a story taken out of the Harlequin romance novels of a previous era. But there is a psychological twist as well. Ana lost her dad when she was young, and her mother appears to be an unrepentant romantic. Mom is so enthralled by handsome men that she smiles when Christian arrives unannounced, even though he is stalking her daughter. Hence, Ana’s psychological backstory is that she is vulnerable to an older, abusive man because of her own losses and trauma.&nbsp;</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif;">There is a debate in the popular media how evil Christian is, and about the degree of abuse that Ana tolerates. Certainly, the fictional relationship between Christian and Ana could hardly be called healthy. <b>Spoiler alert: </b>if it’s any consolation they both leave the relationship with higher levels of insight and knowledge, ending up in better places than they started. (No doubt, their plots will thicken in the sequels!)</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif;">It may be pointless to discuss Christian and Ana in psychological terms since they are Hollywood creations. Yet, in the real world, BDSM is a group of accepted sexual practices among consenting adults and common among those seeking BDSM sex workers (or Dominatrices as they are called.) Often BDSM involves more pain than gain – in other words more tying up and humiliation with less emphasis on the sex and orgasm for the seeker or submissive. When occurring with little harm, most psychiatrists see BDSM as a variant of normal. When it consumes the person and prevents intimacy, the practice may rise to the level of a sexual disorder, sexual compulsivity or even addiction. &nbsp;When the person focuses on a particular inanimate object, like a whip or stiletto heel in lieu of any other sexual or romantic contact, the diagnosis of a fetishitic disorder may apply. &nbsp;</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif;">According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), once an unusual sexual practice causes impairment and harm to oneself or others, it is labeled as a paraphilic disorder with subcategories such as sadism and masochism. The American Psychiatric Association has made it clear that non-normative or unusual sexual behaviors are not, in of themselves, signs of mental illness unless the behaviors cause great anguish or real harm to the participants. This distress has to be beyond the guilt and distress that comes from engaging in behaviors that deviate from societal norms. In the case of BDSM, the DSM-5 is careful to discourage labeling atypical behaviors as mental conditions. However, when the behavior rises to the level of causing grief or harm, DSM-5 offers the diagnoses of sexual sadism disorder and sexual masochism disorder. &nbsp;Psychiatrists can treat these sexual disorders with a variety of modalities ranging from psychotherapy, medication, peer support groups and family counseling with excellent outcomes. &nbsp;As psychiatrists, we need to make the public aware that when these sexual illnesses occur, real help is available.</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif;">Whatever we may think about the sex and stories depicted in “Fifty Shades of Grey,” as psychiatrists, the popularity of the movie provides us with an opportunity to educate the public about the possibilities of improving the lives of those who have serious illnesses and who may suffer in silence and shame.</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif;">Kenneth Paul Rosenberg, MD, is Director of Upper East Health (UpperEastHealth.com), a comprehensive practice in Manhattan that focuses on addiction and sexual disorders. &nbsp;Dr. Rosenberg is also Clinical Associate Professor of Psychiatry at the Cornell Weill Medical Center.&nbsp;</span><br />
<br />American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-39597224101083371012015-02-25T10:36:00.002-05:002015-02-25T13:19:21.524-05:00Eating Disorders Awareness Week 2015: Speak Up and Speak Out <div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">By Deborah R. Glasofer, PhD<o:p></o:p></span></b></div>
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<b><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Reviewed by B. Timothy Walsh, MD<o:p></o:p></span></b></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">This
week marks <a href="http://nedawareness.org/">Eating Disorders Awareness Week</a>. It is a
time to speak up about eating disorders, including anorexia nervosa, bulimia
nervosa and binge eating disorder. Many of us fall prey to messages about what
is and is not beautiful or healthy. For people with eating disorders, however,
the problem extends far beyond any messages heard from the outside world.
Individuals with eating disorders struggle – perhaps because of their biology,
or as a result of persistent behavioral patterns – with critical messages from
within that define health or beauty narrowly or with great distortion.<o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;"><br />Eating
disorders do not discriminate. They impact women and men of all ages, races,
and sizes, although they most often affect girls and women between 12 and 35
years old.<o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;"><br />Eating
disorders do not tread lightly. These are dangerous illnesses characterized by
behaviors (e.g., severely restrictive eating, purging) with potentially
life-threatening physical consequences. They can negatively impact
psychological health – obsessing about food, eating, or body size, rigidity in
thinking, overall anxiety and mood – and <a href="http://thefeedblog.com/2014/09/19/suicide-awareness-not-just-a-depression-problem/">carry an
increased risk of suicide</a>.<o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;"><br />Listen
to learn more about the <a href="http://thefeedblog.com/2014/02/25/blog-talk-radio-series-research-and-future-directions/">latest
breakthroughs in eating disorders understanding and treatment, </a>including
cognitive neuroscience and pharmaceutical research. Read up to learn more from
the Columbia Center for Eating Disorders, a part of the New York State
Psychiatric Institute, about <a href="http://thefeedblog.com/2015/02/23/tips-for-spotting-a-feeding-or-eating-disorder/">spotting an
eating disorder</a> and <a href="http://thefeedblog.com/2014/04/28/call-it-as-you-see-it-advice-to-parents/">approaching a
child</a>
(of any age), <a href="http://thefeedblog.com/2014/11/12/how-to-help-a-teammate-with-eating-problems/">a teammate</a>, <a href="http://thefeedblog.com/2014/06/09/eating-with-disorders/">friend, or
loved one</a>
about whom you are concerned. Listen in to learn more about who’s who on an
eating disorder <a href="http://www.blogtalkradio.com/columbiapsychiatrynyspi/2015/02/23/whos-who-putting-together-your-team-for-eating-disorders-treatment">treatment
team</a>,
and differences between <a href="http://www.blogtalkradio.com/columbiapsychiatrynyspi/2015/02/24/where-to-turn-treatment-settings-and-levels-of-care-for-eating-disorders">treatment
setting options</a>. </span>
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<i style="font-family: Calibri, sans-serif;">Deborah R. Glasofer, PhD, is a clinical
psychologist at the </i><a href="http://www.columbiapsychiatry.org/eatingdisorders"><i><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Columbia
Center for Eating Disorders</span></i></a><i><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> and an
assistant professor of psychology in the Columbia University Department of
Psychiatry. <o:p></o:p></span></i></div>
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American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-60059894943660952092015-02-06T09:36:00.001-05:002015-02-06T09:36:30.607-05:00<h3>
<span style="font-family: Arial, Helvetica, sans-serif;">Wear Red Day: Promoting Healthy Hearts and Healthy Minds&nbsp;</span></h3>
<span style="font-family: Arial, Helvetica, sans-serif;">Erik R. Vanderlip, MD, MPH&nbsp;</span><br />
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<a href="http://2.bp.blogspot.com/-Qk7NPmd6aMQ/VNTPPSWqFcI/AAAAAAAACDI/l32QJq69IbQ/s1600/Wear%2BRed%2BDay.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://2.bp.blogspot.com/-Qk7NPmd6aMQ/VNTPPSWqFcI/AAAAAAAACDI/l32QJq69IbQ/s1600/Wear%2BRed%2BDay.png" /></a></div>
<span style="font-family: Arial, Helvetica, sans-serif;">Researchers today are putting together what it means to truly have a “broken heart.” As we adorn our favorite red apparel for “National Wear Red Day” to raise awareness of the untold stories of millions of women experiencing strokes or heart attacks in our country, we must consider the contribution of poor mental health to this burden.&nbsp;</span><br />
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<a href="http://2.bp.blogspot.com/-NjF3tB4yOAU/VNTO9ydQP3I/AAAAAAAACC8/sBS-LdWTnOw/s1600/Wear%2BRed%2BDay%2Bwomen.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://2.bp.blogspot.com/-NjF3tB4yOAU/VNTO9ydQP3I/AAAAAAAACC8/sBS-LdWTnOw/s1600/Wear%2BRed%2BDay%2Bwomen.jpg" height="180" width="320" /></a><span style="font-family: Arial, Helvetica, sans-serif;">Clinical depression has repeatedly been linked with accelerating the onset of heart attacks and strokes and severely complicating recovery. People with depression often lack the concentration and energy to effectively exercise, eat healthfully, and engage in rehabilitation to optimize recovery. Several studies 1,2 have suggested significant reductions in heart attacks and improved rehabilitation after stroke with proper depression treatment, yet these practices are not yet standard care. Proactively managing our moods and emotions should be granted the same time and effort as lowering our cholesterol, losing weight or dieting. From taking a daily aspirin to taking a walk, keeping tabs on our emotions and addressing them head-on should be an essential part of heart and brain health.&nbsp;</span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br />There are a number of reasons this hasn’t caught on. Cardiologists and primary care physicians are happy to roll up their sleeves to manage cholesterol and lower blood pressure, but when it comes to emotions, many lack the training and expertise to feel confident in diagnosing mental illness, much less manage it. Mental illness is often seen as very subjective, making it challenging to measure or assess.&nbsp;</span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br />Furthermore, mental illness is too often stigmatizing, and many people are embarrassed to admit they’re struggling to cope. Or they may feel as if the overwhelming hopelessness they’re feeling is a natural consequence of having a heart attack or stroke. While it may be common, we know it’s not healthy. Solid, effective treatments exist that we know can help improve our quality of life as well as, perhaps, extend longevity.&nbsp;</span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br />We’re not scared to talk to our doctors about high blood pressure or aspirin, and we shouldn’t be scared to talk to them about our mood. It may be one of the only ways we can begin to mend our broken hearts.&nbsp;</span>
<br />
<h4>
<span style="font-family: Arial, Helvetica, sans-serif;">More information from the American Heart Association:</span></h4>
<span style="font-family: Arial, Helvetica, sans-serif;"></span>
<ul><span style="font-family: Arial, Helvetica, sans-serif;">
<li><a href="http://www.heart.org/HEARTORG/GettingHealthy/StressManagement/HowDoesStressAffectYou/Mental-Health-and-Heart-Health_UCM_438853_Article.jsp" target="_blank">Mental Health and Heart Health</a></li>
<li><a href="http://www.heart.org/HEARTORG/GettingHealthy/StressManagement/HowDoesStressAffectYou/How-does-depression-affect-the-heart_UCM_460263_Article.jsp" target="_blank">How Does Depression Affect the Heart?&nbsp;</a></li>
</span></ul>
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif;">References:&nbsp;</span><br />
<span style="font-family: Arial, Helvetica, sans-serif;">1. Jorge RE, Acion L, Moser D, Adams HP, Robinson RG. Escitalopram and enhancement of cognitive recovery following stroke. Arch Gen Psychiatry. 2010;67(2):187-96. doi:10.1001/archgenpsychiatry.2009.185.<br />
</span><span style="font-family: Arial, Helvetica, sans-serif;">2. Stewart JC, Perkins AJ, Callahan CM. Effect of Collaborative Care for Depression on Risk of Cardiovascular Events: Data From the IMPACT Randomized Controlled Trial. Psychosom Med. 2014;76(1):29-37. doi:10.1097/PSY.0000000000000022.</span>American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-61078553354447517522015-01-23T13:35:00.000-05:002015-01-26T10:05:29.854-05:00You want to do what?!?! The importance of informed consent in treatment<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
<b><span style="font-family: Arial, Helvetica, sans-serif;">By Gail &nbsp;A. Edelsohn, MD, MSPH<o:p></o:p></span></b></div>
<div class="MsoNormal">
<b><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></b></div>
<div class="MsoNormal">
<a href="http://4.bp.blogspot.com/-b7rtqERrhz0/VMKSIoEV9hI/AAAAAAAACCU/xmbHZ9vpawA/s1600/informed%2Bconsent.jpg" imageanchor="1" style="clear: right; display: inline !important; float: right; font-family: Arial, Helvetica, sans-serif; margin-bottom: 1em; margin-left: 1em; text-align: center;"><img border="0" src="http://4.bp.blogspot.com/-b7rtqERrhz0/VMKSIoEV9hI/AAAAAAAACCU/xmbHZ9vpawA/s1600/informed%2Bconsent.jpg" height="132" width="200" /></a><span style="font-family: Arial, Helvetica, sans-serif;">We come across ads in print, on television
and on the Internet for medications and therapies that promise to make your child
do his homework without a screaming match, behave better and generally restore
harmony to home life. Not so easy, taking a medication raises a host of
questions: &nbsp;How long does the therapy
take? Should I as the parent sign off on this? What about the possible serious
side effects, such as significant weight gain, thoughts about suicide, risk of
diabetes or a life-threatening condition?</span></div>
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<br />
<span style="font-family: Arial, Helvetica, sans-serif;"><o:p></o:p></span><br />
<div class="MsoNormal">
<a href="http://4.bp.blogspot.com/-HeciXDK2dw4/VMKSI2uAVpI/AAAAAAAACCc/AIUV_aeHD8s/s1600/African%2BAmerican%2Bfamily.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img alt="" border="0" src="http://4.bp.blogspot.com/-HeciXDK2dw4/VMKSI2uAVpI/AAAAAAAACCc/AIUV_aeHD8s/s1600/African%2BAmerican%2Bfamily.jpg" height="200" title="" width="134" /></a><span style="font-family: Arial, Helvetica, sans-serif;">Parents and legal guardians make
decisions about psychosocial therapy and medication treatment for children and
adolescents every day. But who should give permission and sign informed
consent?&nbsp; What should parents, advocates,
guardians be looking for or consider before signing informed consent? Is
signing a form enough?&nbsp; What about the child
or teen - do they have a voice regarding their own treatment?<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif;">What is Informed Consent?</span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif;">Psychiatric informed consent
involves a parent or legal guardian <i>giving
permission</i> for his/her child to undergo evaluation and treatment<span style="color: red;">.</span>&nbsp; It is a
process which partly involves receiving sufficient relevant information about
the condition, prognosis, risks and benefits of treatment to be given and other
types of treatment available. Informed consent is NOT simply a signed and dated
form. Parents and guardian should expect informed consent to include<s>:<o:p></o:p></s></span></div>
<div class="MsoListParagraphCxSpFirst" style="text-indent: -0.25in;">
<a href="http://1.bp.blogspot.com/-PVXVzXVuVuQ/VMKSI6_ILpI/AAAAAAAACCY/3I9_TqOOh5A/s1600/father%2B%26%2Bboy.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://1.bp.blogspot.com/-PVXVzXVuVuQ/VMKSI6_ILpI/AAAAAAAACCY/3I9_TqOOh5A/s1600/father%2B%26%2Bboy.jpg" height="115" width="200" /></a><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-stretch: normal;"><br /></span></span></div>
<span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-stretch: normal;">&nbsp;&nbsp;</span>The purpose of the treatment</span><br />
<ul>
<li><span style="text-indent: -0.25in;"><span style="font-family: Arial, Helvetica, sans-serif;">To address a specific condition or diagnosis?</span></span></li>
</ul>
<ul>
<li><span style="text-indent: -0.25in;"><span style="font-family: Arial, Helvetica, sans-serif;">To lessen symptoms?</span></span></li>
</ul>
<ul>
<li><span style="font-family: Arial, Helvetica, sans-serif;"><span style="text-indent: -0.25in;"><span style="font-stretch: normal;">&nbsp;</span></span><span style="text-indent: -0.25in;">To change behaviors?</span></span></li>
</ul>
<span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-stretch: normal;">&nbsp;&nbsp;</span>The effects of treatment</span><br />
<ul>
<li><span style="text-indent: -0.25in;"><span style="font-family: Arial, Helvetica, sans-serif;">How will you know if it is working?</span></span></li>
</ul>
<ul>
<li><span style="font-family: Arial, Helvetica, sans-serif;"><span style="text-indent: -0.25in;"><span style="font-stretch: normal;">&nbsp;</span></span><span style="text-indent: -0.25in;">How long till you see an effect?</span></span></li>
</ul>
<span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-stretch: normal;">&nbsp;&nbsp;</span>Risks of treatment</span><br />
<ul>
<li><span style="text-indent: -0.25in;"><span style="font-family: Arial, Helvetica, sans-serif;">Side effects of medications</span></span></li>
</ul>
<ul>
<li><span style="text-indent: -0.25in;"><span style="font-family: Arial, Helvetica, sans-serif;">Consequences of psychosocial treatment (e.g., therapy
can be emotionally difficult)</span></span></li>
</ul>
<span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-stretch: normal;">&nbsp;&nbsp;</span>Risks of NO treatment</span><br />
<ul>
<li><span style="text-indent: -0.25in;"><span style="font-family: Arial, Helvetica, sans-serif;">Will symptoms improve over time without
treatment?</span></span></li>
</ul>
<ul>
<li><span style="text-indent: -0.25in;"><span style="font-family: Arial, Helvetica, sans-serif;">Will things get worse or lead to other
consequences? (e.g., Untreated individuals are more likely to use substances,
get into legal trouble)</span></span></li>
</ul>
<span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-stretch: normal;">&nbsp;&nbsp;</span>What alternative treatments are available?<br /><span style="font-stretch: normal;">&nbsp;&nbsp;</span></span><br />
<span style="font-family: Arial, Helvetica, sans-serif;">For medication</span><br />
<ul>
<li><span style="text-indent: -0.25in;"><span style="font-family: Arial, Helvetica, sans-serif;">Is it FDA approved for this age and condition?
(i.e., prescribed FDA on label)</span></span></li>
</ul>
<ul>
<li><span style="text-indent: -0.25in;"><span style="font-family: Arial, Helvetica, sans-serif;">If it is prescribed off-label, why?</span></span></li>
</ul>
<ul>
<li><span style="text-indent: -0.25in;"><span style="font-family: Arial, Helvetica, sans-serif;">Are there any FDA warnings about the medication
and what do they mean?</span></span></li>
</ul>
<ul>
<li><span style="text-indent: -0.25in;"><span style="font-family: Arial, Helvetica, sans-serif;">What is the plan for stopping or phasing out the
medication?</span></span></li>
</ul>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 1in; text-indent: -0.25in;">
<span style="font-family: Arial, Helvetica, sans-serif;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 1in; text-indent: -0.25in;">
<span style="font-family: Arial, Helvetica, sans-serif;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 1in; text-indent: -0.25in;">
<span style="font-family: Arial, Helvetica, sans-serif;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="text-indent: -0.25in;">
<span style="font-family: Arial, Helvetica, sans-serif;">&nbsp; &nbsp; &nbsp;Parents and legal guardians are
asked to give legal permission or informed consent for treatment. </span><span style="font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;">&nbsp;</span><span style="font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;">If a child is in foster care, it may be the
parent or it may be child welfare service or court that can give consent. </span><span style="font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;">&nbsp;&nbsp;</span><span style="font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;">Where a child is living (home, out of home
placement) does not tell you who the legal guardian is.</span><span style="font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;">&nbsp; </span><span style="font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;">In some states an adolescent may give
informed consent for psychiatric treatment depending on the state’s legislation
about mental health procedures. Ideally the parents/guardians and the child
should be involved in treatment decision making.</span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif;"><br />Children also have a voice in
this process.&nbsp; Children and youth should
be involved in giving <b><i>assent.</i></b>&nbsp; Assent involves providing the child or teen
with information about the therapy or medication in terms appropriate to their
age and stage of development. The assent process should include opportunities
for the child/adolescent to ask questions and have their concerns addressed.<o:p></o:p></span></div>
<br />
<div class="MsoNormal">
<i><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></span></i>
<i><span style="font-family: Arial, Helvetica, sans-serif;">Gail A.
Edelsohn, MD, MSPH, is senior medical officer with Community Care Behavioral
Health, clinical professor of psychiatry and human behavior,&nbsp; Jefferson
Medical College, and clinical professor of psychiatry and behavioral science,
Temple University School of Medicine.</span></span></i></div>
American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-27655417649774772692015-01-02T08:27:00.001-05:002015-01-23T13:18:05.038-05:00The Power of Words: Addressing the Stigma of Mental Illness<div class="MsoNormal">
<span style="font-family: Calibri, sans-serif; font-size: 11pt;">J</span><span style="font-size: 11pt;"><span style="font-family: Arial, Helvetica, sans-serif;">enna Bowen, medical student, University of Wisconsin</span></span></div>
<div class="MsoNormal">
<span style="font-size: 11pt;"><span style="font-family: Arial, Helvetica, sans-serif;">Reviewed by Claudia Reardon, MD <b><i><o:p></o:p></i></b></span></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://4.bp.blogspot.com/-r1vhoYu-Uqs/VKafWBF0nwI/AAAAAAAACCA/7rbsf7cLwl8/s1600/stigma%2BSTOP.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://4.bp.blogspot.com/-r1vhoYu-Uqs/VKafWBF0nwI/AAAAAAAACCA/7rbsf7cLwl8/s1600/stigma%2BSTOP.jpg" height="132" width="200" /></a></div>
<span style="font-size: 11pt;"><span style="font-family: Arial, Helvetica, sans-serif;">Crazy.&nbsp; Insane. &nbsp;Deranged. Mad. &nbsp;Lunatic. —Misused as nouns, adjectives and
lay-diagnoses, their use perpetuates stereotypes of the wide variety of people
who experience mental illness. <o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif; font-size: 11pt;">Maybe you know someone or, more likely, a number of people who
experience depression, anxiety, bipolar disorder or other brain disorders.&nbsp; According to the National Institute of Mental
Health, 1 in 4 American adults and 1 in 5 American youth experience a form of
mental illness every year. People with mental illness are teachers, accountants,
neighbors, sisters, fathers and friends. Anyone you know could be experiencing
mental illness, but afraid to come forward and be treated. Maybe that person is
</span><i style="font-family: Arial, Helvetica, sans-serif; font-size: 11pt;">you.</i></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 11pt;">People living with mental illness continue to have an identity
that is beyond a diagnosis, similar to other medical conditions. While managing
mental illness may be challenging at times—similar to challenges faced by
people with diabetes, high blood pressure, or other medical illness— there is
greater difficulty in getting the treatment needed because of feelings of shame
and stigma surrounding mental illness. However, treatment for mental illness
works. Research shows the majority (65 percent to 80 percent) of individuals
with mental disorders will improve with appropriate treatment</span> and ongoing
monitoring.</span><span style="font-size: 11pt;"><span style="font-family: Arial, Helvetica, sans-serif;"> People with mental illness need to know that they will continue
to be seen as people – your brother, best friend, daughter —and not “crazed” or
“insane” if they appropriately seek help for a treatable medical condition that
they happen to be experiencing.</span></span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://1.bp.blogspot.com/-3OghMKDirIM/VKabTPKX6JI/AAAAAAAACBs/-lv07YsWax8/s1600/Bring%2BChange%2B2%2BMind%2Blogo.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://1.bp.blogspot.com/-3OghMKDirIM/VKabTPKX6JI/AAAAAAAACBs/-lv07YsWax8/s1600/Bring%2BChange%2B2%2BMind%2Blogo.JPG" height="137" width="200" /></a></div>
<span style="font-family: Arial, Helvetica, sans-serif; font-size: 11pt;">Bring Change 2 Mind, an organization aimed to end stigma and
discrimination surrounding mental illness, offers recommendations to reduce
your impact on the stigma surrounding those with mental illness.</span><br />
<div class="MsoListParagraphCxSpFirst" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
</div>
<ul>
<li><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 11pt; text-indent: -0.25in;">Use "person first" vocabulary. When we say a person is
schizophrenic, we make their mental illness fully define their identity.
Instead, be clear that this is a disease that individuals manage and live with—
"He is living with schizophrenia."</span></span></li>
<li><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 11pt; text-indent: -0.25in;">Avoid the verb "suffers" when discussing mental illness.
Instead, choose, "lives with mental illness" or "is affected by
mental illness."</span></span></li>
<li><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 11pt; text-indent: -0.25in;">There are many phrases and terms; "crazy,"
"nuts", "psycho", "schizo", "retard"
and "lunatic" that may seem insignificant, but really aren't.</span></span></li>
</ul>
<br />
<div class="MsoNormal">
<a href="http://1.bp.blogspot.com/-CjMz82RVfHQ/VKabTIiQ46I/AAAAAAAACBw/4hlkkPCDaKU/s1600/Bring%2BChange%2B2%2BMind%2Bgroup.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><span style="font-family: Arial, Helvetica, sans-serif;"><img border="0" src="http://1.bp.blogspot.com/-CjMz82RVfHQ/VKabTIiQ46I/AAAAAAAACBw/4hlkkPCDaKU/s1600/Bring%2BChange%2B2%2BMind%2Bgroup.JPG" height="130" width="400" /></span></a><span style="font-size: 11pt;"><span style="font-family: Arial, Helvetica, sans-serif;">Be an advocate for those that you know, and the many that you
don’t know, who are living with some form of mental illness by breaking down stigma,
and being conscious of language surrounding brain disorders<b><i>.&nbsp;</i></b>To learn more check
out:<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l1 level1 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 11pt;">·<span style="font-size: 7pt; font-stretch: normal;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span><!--[endif]--><a href="http://bringchange2mind.org/get-involved/spread-the-word/"><span style="font-size: 11pt;">Bring
Change 2 Mind</span></a><span style="font-size: 11pt;"> <o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 11pt;">·<span style="font-size: 7pt; font-stretch: normal;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span><!--[endif]--><a href="http://www.nami.org/Content/NavigationMenu/Take_Action/Fight_Stigma/Fight_Stigma_StigmaBusters.htm"><span style="font-size: 11pt;">NAMI
– Stigma Busters</span></a><span style="font-size: 11pt;"> <o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 11pt;">·<span style="font-size: 7pt; font-stretch: normal;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span><!--[endif]--><a href="http://promoteacceptance.samhsa.gov/"><span style="font-size: 11pt;">Resource Center to Promote&nbsp;Acceptance, Dignity and<br />&nbsp;Social Inclusion Associated with Mental Health</span></a><span style="font-size: 11pt;"> (SAMHSA)</span><span style="font-size: 11pt;"><o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 11pt;">·<span style="font-size: 7pt; font-stretch: normal;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span><!--[endif]--><span style="font-size: 11pt;"><a href="http://www.psychiatry.org/advocacy--newsroom/newsroom/reporting-on-mental-illness">Mental
Health Terminology:&nbsp; Words Matter</a></span><span style="font-size: 11pt;"><o:p></o:p></span></span></div>
<br />
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American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-56428484500930148572014-12-05T11:57:00.001-05:002015-01-23T14:39:40.398-05:00Study highlights lack of access to mental health care<b>By Arshya Vahabzadeh,MD&nbsp;</b><br />
&nbsp;@VahabzadehMD<br />
<br />
A new study from the CDC’s National Center for Health Statistics once again highlights that too many people living with mental health conditions are not getting needed care.<br />
<br />
Study authors Laura A. Pratt, PhD, and Debra J. Brody, MPH, found that nearly 8% of Americans aged 12 and up had depression (moderate or severe depressive symptoms in the past 2 weeks). The rate of depression was twice as high among people living below the poverty level, 15%.<br />
<br />
&nbsp;Far more alarming, the study showed yet again that people with depression are going untreated. While nearly 90% of people with severe depressive symptoms reported difficulty with work, home, or social activities related to their symptoms, only about one-third (35.3%) had seen a mental health professional in the past year, according to the study. Among those with moderate depressive symptoms, only 1 in 5 had seen a mental health professional.<br />
<br />
While there are many reasons people don’t get needed mental health care, including mental health stigma and lack of access, discrimination in mental health coverage by insurance companies shouldn’t be among the reasons. Federal law now requires that insurers cover mental health illnesses the same as physical ailments, such as heart disease, diabetes and cancer.<br />
<br />
<a href="http://4.bp.blogspot.com/-NNLbfdGWq4M/VIHjIdvYD-I/AAAAAAAACAk/MMYz_9FG7Bg/s1600/parity%2Bposter%2Bimage.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-NNLbfdGWq4M/VIHjIdvYD-I/AAAAAAAACAk/MMYz_9FG7Bg/s1600/parity%2Bposter%2Bimage.JPG" height="320" width="206" /></a><br />
However, many people don’t know their rights when it comes to getting mental health treatment. To address this glaring problem, the American Psychiatric Association has released a new poster -- <br />
available to mental health professionals -- that explains in simple terms your rights under the law and what to do if you think your rights are being denied. Download a copy at <a href="http://www.psychiatry.org/parity.">www.psychiatry.org/parity.</a> <br />
<br />American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-482866577218238812014-12-02T08:48:00.002-05:002015-01-23T14:42:02.060-05:00World AIDS Day<div align="center" class="MsoNormal" style="text-align: center;">
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<span style="font-family: Arial, Helvetica, sans-serif; font-weight: bold; line-height: 21.4666652679443px;">By Annelle Primm, MD, MPH</span></div>
<b><span lang="EN" style="font-size: 14pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;"><br />
World AIDS Day<br />
December 1, 2014<o:p></o:p></span></span></b></div>
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<span style="font-family: Arial, Helvetica, sans-serif;"><b><i><span lang="EN" style="font-size: 12pt; line-height: 115%;">Focus, Partner, Achieve:&nbsp; An AIDS-Free Generation</span></i></b><b><span style="font-size: 12pt; line-height: 115%;"><o:p></o:p></span></b></span></div>
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World AIDS Day is a key opportunity to raise awareness and to commemorate those who lost their lives to this often deadly disease. But, today, we can also be hopeful about achieving an AIDS-free generation.&nbsp; Increased access to treatment, new and better prevention services and care, and <i>advances</i> in treatment are all reasons for hopefulness. &nbsp;And that amounts to greater peace of mind. </span></div>
<span style="font-family: Arial, Helvetica, sans-serif;"><a href="http://4.bp.blogspot.com/-pr6cRSX5vC4/VH3AN5A7EYI/AAAAAAAAADk/yGt5EfiFby0/s1600/20141120-WorldAidsDay-Graphic2.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://4.bp.blogspot.com/-pr6cRSX5vC4/VH3AN5A7EYI/AAAAAAAAADk/yGt5EfiFby0/s1600/20141120-WorldAidsDay-Graphic2.jpg" height="200" width="200" /></a>&nbsp;</span><br />
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<span style="font-family: Arial, Helvetica, sans-serif;">An estimated 35 million people worldwide have HIV and more than 39 million people have died from the virus since the first cases in 1981. <b>In the U.S., </b></span><b><span style="font-family: Arial, Helvetica, sans-serif;">more than 1.2 million people live with HIV, but nearly 1 in 7 of those don’t know they have the virus.</span><o:p></o:p></b></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">An estimated 50,000 people in the U.S. are newly infected each year.&nbsp; It’s why I continue to tell people the importance of getting tested.&nbsp; There’s no shame, just a need for information.<o:p></o:p></span></div>
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<b>What is the Connection Between HIV and Mental Health? <br />
<o:p></o:p></b></span></div>
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<a href="http://2.bp.blogspot.com/-lLRcRBcFcc4/VH3ARJWRn3I/AAAAAAAAADs/3zilmIvf4Io/s1600/20141120-WorldAidsDay-Graphic4.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://2.bp.blogspot.com/-lLRcRBcFcc4/VH3ARJWRn3I/AAAAAAAAADs/3zilmIvf4Io/s1600/20141120-WorldAidsDay-Graphic4.jpg" height="200" width="200" /></a><span style="font-size: 11pt;">Mental and neurological disorders have an intertwined and often complex relationship with HIV and AIDS. Yet mental health issues are often overlooked in HIV interventions and treatment. <o:p></o:p></span></div>
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<li><span style="font-size: 11pt; text-indent: -13.5pt;"><span style="font-family: Arial, Helvetica, sans-serif;">About 60% of people with HIV also have depression.&nbsp; Sometimes one may be tempted to “blame” depression on their HIV status, but the reality is that depression can happen to anyone and treatment works</span></span></li>
<li><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 11pt; text-indent: -13.5pt;">Pre-existing mental disorders (including substance use) can complicate HIV-related illness.&nbsp; It’s important for physicians to know all they need to know about your health, and for you to be comfortable sharing &nbsp;</span></span></li>
<li><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 11pt; text-indent: -13.5pt;">Nearly 50% of people with HIV experience impaired motor skills, trouble with memory and poor concentration.&nbsp; If you experience such changes, those are important to inform your doctor about</span></span></li>
<li><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 11pt; text-indent: -13.5pt;">Mental illness can make it more difficult for people to adhere to HIV-medication regimens</span></span></li>
<li><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 11pt; text-indent: -13.5pt;">New antiretroviral treatments and combination therapies can affect the central nervous system and/or have psychiatric side effects</span></span></li>
<li><span style="font-family: Arial, Helvetica, sans-serif;"><tt style="text-indent: -13.5pt;"><span style="font-size: 11pt;"><span style="font-family: Arial, Helvetica, sans-serif;">Mental illnesses can be especially challenging to recognize and diagnose in people with HIV/AIDS.&nbsp; That’s why the APA works to educate and provide tools and training to physicians.</span></span></tt></span></li>
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<a href="http://1.bp.blogspot.com/-4MFvwgLXz-Q/VH3ARKVtpVI/AAAAAAAAADw/HUuj0Uuafjs/s1600/20141120-WorldAidsDay-Graphic3.jpg" imageanchor="1" style="clear: left; display: inline !important; float: left; margin-bottom: 1em; margin-right: 1em; text-align: center;"><img border="0" src="http://1.bp.blogspot.com/-4MFvwgLXz-Q/VH3ARKVtpVI/AAAAAAAAADw/HUuj0Uuafjs/s1600/20141120-WorldAidsDay-Graphic3.jpg" height="200" width="200" /></a><br />
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<span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 11pt;">Unfortunately, both HIV and mental illness still carry a significant burden of stigma and discrimination.<br />
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As HIV/AIDS increasingly becomes a chronic disorder with the improvement of treatments, the need for mental health care and services is rising.&nbsp; World AIDS Day is also a day to recognize the many psychiatrists and other mental health clinicians working with HIV patients who also have complicated psychiatric or substance use comorbidities. <br />
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Looking for ways to take action?</span></b><span lang="EN" style="font-size: 11pt;">&nbsp; <i>Here are a few simple, powerful, and engaging ways you can take action</i>:<o:p></o:p></span></span></div>
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<li><span lang="EN" style="font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;">Know your HIV status. Use and share the </span><a href="http://aids.gov/locator/" style="font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;"><span lang="EN">HIV Testing Sites &amp; Care Services Locator</span></a><span lang="EN" style="color: blue; font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;">&nbsp;&nbsp;</span></li>
<li><span style="background-color: transparent; font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;">Share your message on social media using #FacingAIDS or</span><span style="background-color: transparent; font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;">&nbsp; </span><span style="background-color: transparent; font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;">in the </span><a href="http://facing.aids.gov/gallery/" style="background-color: transparent; font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;" title="http://facing.aids.gov/gallery/">Facing AIDS gallery</a></li>
<li><span style="background-color: transparent; font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;">Learn about HIV/AIDS with the </span><a href="http://aids.gov/hiv-aids-basics/" style="background-color: transparent; font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;">HIV/AIDS Basics</a><span style="background-color: transparent; font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;">. A</span><span style="background-color: transparent; font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;">sk questions. Get help.</span></li>
<li><span style="background-color: transparent; font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;">Take a quiz:</span><span style="background-color: transparent; font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;">&nbsp; </span><a href="http://www.hivawarequiz.org.uk/quiz-3/about-you" style="background-color: transparent; font-family: Arial, Helvetica, sans-serif; text-indent: -0.25in;">Are you HIV Aware?</a><b style="background-color: transparent; text-indent: -0.25in;"><span style="font-family: Arial, Helvetica, sans-serif;">&nbsp;</span></b></li>
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Annelle Primm, MD, MPH is the Deputy Medical Director of the American Psychiatric Association</div>
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APA Healthy Mindshttp://www.blogger.com/profile/15219956620192752515noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-78869831983790024012014-11-10T12:08:00.000-05:002015-01-23T14:46:01.042-05:00Native Americans and Suicide<span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">By Arshya
Vahabzadeh, MD &amp; Brad Zehring, DO <o:p></o:p></span></b><br />
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&nbsp;</span><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Mental illness does not discriminate - it affects every age, sex, religion, and ethnic group. <o:p></o:p></span><br />
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<span style="color: black; font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-fareast-font-family: &quot;Times New Roman&quot;; mso-hansi-theme-font: major-latin;">The Indian Health Service conducted a study in 2008 that noted that the rate of <a href="http://www.psychiatry.org/mental-health/key-topics/suicide"><span style="color: blue;">suicide</span></a> for <a href="http://www.psychiatry.org/mental-health/people/american-indians-"><span style="color: blue;">American Indians and Alaska Natives</span></a> is higher than any ethnic group within the United States. The study reported that suicide in these populations is up to 70% higher, especially in ages 10 to 24. Sadly, this statistic is not decreasing. Mental health professionals and society need to recognize the etiology of the despair that leads to suicide so that treatment and appropriate allocation of resources can be made.<o:p></o:p></span></div>
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<span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">The statistics are alarming, but possibly more alarming is the silence around this tragedy. Since suicide is taboo on most reservations - there are reports that a death by suicide often is not reported or legal authorities classify it as an accident. Due to the silence and misrepresentation, the numbers could be even greater. <o:p></o:p></span><br />
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<span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">It is important to break the silence on the troubling trends within Native American reservations. <a href="http://www.psychiatry.org/File%20Library/Practice/Diversity/Diversity%20Resources/Fact-Sheet---Native-Americans.pdf"><span style="color: blue;">Native Americans</span></a> must be willing to discuss their stressors and be open to getting education necessary to cope, deal, and treat their stressors. Mental Health professionals must be willing to understand their culture and adapt. Alex Crosby, MD, MPH, medical epidemiologist of the CDC has been recorded as saying that Native American suicide is so prevalent that it has become acceptable practice when tensions build up. Suicide should never be an acceptable option.<o:p></o:p></span><br />
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Reasons for troubling trends among Native Americans<o:p></o:p></span></b><br />
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<a href="http://1.bp.blogspot.com/-YlySxRrhisE/VGDrjKPrFxI/AAAAAAAAADU/wYc1zBqcsWA/s1600/Native%2BAmer%2Blets%2Btalk%2Bfacts.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://1.bp.blogspot.com/-YlySxRrhisE/VGDrjKPrFxI/AAAAAAAAADU/wYc1zBqcsWA/s1600/Native%2BAmer%2Blets%2Btalk%2Bfacts.JPG" height="200" width="82" /></a></div>
<span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">There are a lot of thoughts on why mental illness and suicide have increased in the <a href="http://www.psychiatry.org/File%20Library/Mental%20IIlness/Lets%20Talk%20Facts/APA_American-Indians.pdf"><span style="color: blue;">Native American population</span></a>. There has been a lot of discussion of generational trauma due to the disempowerment and oppression of Native Americans and Alaska Natives. It has been discussed that this has caused adverse childhood experiences that lead to high rates of depression and other mental illness that are precursors to suicide. </span><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-fareast-font-family: &quot;Times New Roman&quot;; mso-hansi-theme-font: major-latin;"><o:p></o:p></span><br />
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<span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">While disempowerment and oppression could very well be contributing factors - poverty seems to be a growing problem on reservations. Poverty tends to put stress on educational standards decreasing the educational opportunities for those on the reservation – leading to a viscous cycle. There are few jobs on the reservation causing adolescents and young adults to leave their families and move to where there are jobs. However, parents age and get ill causing tension between the traditional Native American family structures where youth takes care of the elderly and providing for the immediate family. <o:p></o:p></span></div>
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<span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">In addition to poverty, substance abuse is a big problem on the reservation. Substance abuse can affect mood, often negatively, which increases the tension and is a risk factor for suicide. Domestic violence and sexual assault are also known problems on the reservation. These stressors have led to unstable environments for children growing up. Add untreated mental illness to the mix and it is easy to see how hopelessness and despair thrive often leading to the belief that suicide is the only way out.<o:p></o:p></span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">The Way Forward<o:p></o:p></span></b></div>
<span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Recently, the American Foundation for Suicide Prevention joined a Native American Mental Health panel sponsored by Congressional Native American Caucus and Center for Native American Youth. The panel focused on ways of improving mental health resources and suicide prevention. The IHS and the Substance Abuse and Mental Health Services Administration (SAMHSA) collaborated on targeted suicide prevention programs. The IHS established the <span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ansi-language: EN-US; mso-ascii-theme-font: major-latin; mso-bidi-language: AR-SA; mso-bidi-theme-font: major-latin; mso-fareast-font-family: &quot;MS Mincho&quot;; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: major-latin;">Suicide Prevention Initiative </span>and SAMHSA provided funding to the IHS to address youth suicide and provide suicide prevention for high-risk populations. <o:p></o:p></span><br />
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<span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">As we move forward as Mental Health professionals, it will be important to continue to collaborate with the Native American population, especially with Mental Health professionals with experience with the population and their culture. Understanding their culture and etiology of stressors will go a long way in providing the appropriate resources and treatment.<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div>
<b style="mso-bidi-font-weight: normal;"><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Resources for Help<o:p></o:p></span></b><br />
<b style="mso-bidi-font-weight: normal;"><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">In the US: <o:p></o:p></span></b><br />
<span style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal &quot;Times New Roman&quot;;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><a href="http://www.helpguide.org/articles/suicide-prevention/suicide-help-dealing-with-your-suicidal-thoughts-and-feelings.htm"><span style="color: blue;">Suicide help</span></a> <o:p></o:p></span><br />
<span style="color: black; font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal &quot;Times New Roman&quot;;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><span style="color: black; font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">1-800-273-TALK</span><br />
<span style="color: black; font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><o:p></o:p></span><br />
<b style="mso-bidi-font-weight: normal;"><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Outside the US:<o:p></o:p></span></b><br />
<span style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal &quot;Times New Roman&quot;;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-ascii-theme-font: major-latin; mso-bidi-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><a href="http://www.iasp.info/resources/Crisis_Centres/"><span style="color: blue;">International Association of Suicide Prevention (IASP)</span></a> <o:p></o:p></span>APA Healthy Mindshttp://www.blogger.com/profile/15219956620192752515noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-7825355354044788572014-10-20T11:13:00.000-04:002014-10-20T11:13:49.715-04:0015 Tips for Talking to Kids about Ebola <div class="MsoNormal" style="text-align: left;">
<b><span style="font-family: inherit;">By David Fassler, M.D.</span></b></div>
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<i><span style="font-family: inherit;">Child and adolescent psychiatrist&nbsp;</span></i></div>
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<span style="font-family: inherit;">Parents and teachers may find themselves faced with the challenge of
discussing the evolving Ebola epidemic with children. Although these may
be difficult conversations, they are also important.&nbsp;There are no “right” or “wrong” ways to talk
with kids about Ebola, but here are some suggestions if you need help.&nbsp;</span></div>
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<span style="font-family: inherit;"><b>1.</b> Provide an open and supportive environment where children
know they can ask questions. At the same time, it’s best not to force children
to talk about Ebola unless and until they’re ready.</span></div>
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<span style="font-family: inherit;"><b>2.</b> Answer questions honestly. Kids will usually know,
or eventually find out,&nbsp;</span><span style="font-family: inherit;">if you’re “making things up." It may affect their trust in you or your reassurances in the future.</span></div>
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<span style="font-family: inherit;"><b>3.</b> Use words and ideas children can understand. Gear
your explanations to the child’s age, language, and developmental level.</span></div>
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<span style="font-family: inherit;"><b>4.</b> Help kids find<b> accurate</b> and up to date
information.&nbsp;Print out Fact Sheets from
the <a href="http://www.cdc.gov/vhf/ebola/pdf/what-need-to-know-ebola.pdf" target="_blank">CDC</a>, <a href="http://www.cnn.com/2014/10/09/health/ebola-q-and-a/" target="_blank">CNN</a>, <a href="http://www.who.int/mediacentre/factsheets/fs103/en/" target="_blank">WHO</a> and <a href="http://kidshealth.org/parent/infections/bacterial_viral/ebola.html" target="_blank">kidshealth.org</a>.</span></div>
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<span style="font-family: inherit;"><b>5.</b> Be ready to repeat information and explanations
several times.&nbsp;Some information may be
hard to accept or understand. Asking the same question over and over may also
be a way for a child to ask for reassurance.</span></div>
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<span style="font-family: inherit;"><b>6. </b>Acknowledge and validate the child’s thoughts, feelings,
and reactions. Let them know that you think their questions and concerns are
important and appropriate.</span></div>
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<a href="http://1.bp.blogspot.com/-gnTRe9FtHng/VEUjek78AoI/AAAAAAAAB_8/oFjLj7VbmsE/s1600/talkingwithdad.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/-gnTRe9FtHng/VEUjek78AoI/AAAAAAAAB_8/oFjLj7VbmsE/s1600/talkingwithdad.jpg" height="212" width="320" /></a></div>
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<span style="font-family: inherit;"><b>7. </b>Remember that kids often <b>personalize situations.</b>
For example, they may worry about their own safety and the safety of family members.&nbsp;They may also worry
about friends or relatives who travel or live far away.</span></div>
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<span style="font-family: inherit;"><b>8.</b> Be comforting, but don’t make unrealistic promises. It’s
fine to let children know that they are safe in their home or at school. But you can’t promise that there will be no cases of Ebola in your state or
community.</span></div>
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<span style="font-family: inherit;"><b>9.</b> Let kids know that there are lots of people helping
the families affected by Ebola.&nbsp;This time is&nbsp;a good opportunity to show children that when something scary or
bad happens, there are people to help.</span></div>
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<span style="font-family: inherit;"><b>10.</b> Children learn from watching their parents and
teachers. They will be very interested in how <i><b>you</b></i> react to news about Ebola. They also learn from listening to your conversations with other adults.</span></div>
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<span style="font-family: inherit;"><b>11.</b> Don’t let kids watch too much television with
frightening images. The repetition of such scenes can be disturbing and confusing.</span></div>
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<span style="font-family: inherit;"><b>12.</b> Children who have experienced serious illness, loss, or other <a href="http://www.psychiatry.org/mental-health/coping-with-disasters" target="_blank">traumatic events</a> in the past are particularly vulnerable to graphic
news reports or images of death. These children may need extra support and
attention.</span></div>
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<span style="font-family: inherit;"><b>13. </b>Watch for physical symptoms including <b>headaches and
stomachaches</b>. Often times, kids express <a href="http://www.psychiatry.org/anxiety-disorders" target="_blank">anxiety</a> through physical aches and pains.
An increase in such symptoms without apparent medical cause may be a sign that
a child is feeling anxious or overwhelmed.</span></div>
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<span style="font-family: inherit;"><b>14.</b> Children who are consumed with questions or worry about Ebola should be evaluated by a trained and qualified <a href="http://www.psychiatry.org/mental-health/more-topics/what-is-a-psychiatrist" target="_blank">mental health professional</a>. Other signs that a child may need additional care include:
<b>ongoing sleep problems, frequent fears
about illness or death, or reluctance to leave parents or go to school.</b> If such
behaviors continue, ask your child’s pediatrician, family physician, or school
counselor to help you contact a mental health professional.&nbsp;</span></div>
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<span style="font-family: inherit;"><b>15.</b> Although parents and teachers may follow the news and
the daily updates with interest and attention, <b><i>most kids just want to be kids</i>.</b> They may not want to think about what’s happening across the country
or elsewhere in the world. They’d rather play ball, climb trees, or ride bikes.</span></div>
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<span style="font-family: inherit;">Public health emergencies are not easy for anyone to
comprehend or accept. Understandably, many young children feel frightened and
confused. &nbsp;As parents, teachers, and
caring adults, we can best help by listening and responding honestly and comfortingly.&nbsp;Fortunately, most children, even those who have experienced loss or illness, are quite resilient. &nbsp;However, by creating an open environment where
they feel free to ask questions, we can help them cope with stressful events
and experiences.<o:p></o:p></span></div>
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<br /></div>
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<i><span style="font-family: inherit;">David Fassler, M.D., is a child and adolescent psychiatrist
practicing in Burlington, Vermont. He is also a Clinical Professor of
Psychiatry at the University of Vermont.<o:p></o:p></span></i></div>
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<br /></div>
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</script>American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-34342623682848855182014-10-07T14:26:00.002-04:002015-01-23T14:56:29.805-05:00Adult Bullying in the Workplace<br />
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<strong>By Brad Zehring, DO</strong> </div>
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</div>
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<span style="font-family: inherit;"><i>I would rather be a
little nobody, then to be an evil somebody</i> - Abraham Lincoln <o:p></o:p></span></div>
<span style="font-family: inherit;"><br /></span>
<br />
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<span style="font-family: Arial, Helvetica, sans-serif;">Typically, when bullying is talked about it is in the
context of children or adolescents during some level of schooling. Rarely do we
think about<a href="http://www.nxtbook.com/nxtbooks/apf/mentalhealthworks_2012q2/#/6" target="_blank"> bullying as an adult issue.</a> However, much more attention has been
focused on adult bullying – more specifically, adult bullying in the </span><a href="http://www.nxtbook.com/nxtbooks/apf/mentalhealthworks_2012q2/#/6" target="_blank"><span style="font-family: Arial, Helvetica, sans-serif;">workplace.</span><span style="font-family: inherit;"><o:p></o:p></span></a></div>
<span style="font-family: inherit;"><br /></span>
<br />
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<a href="http://4.bp.blogspot.com/-CFpTxUHQFGk/VDQd6RNKsWI/AAAAAAAAB_c/3rqYi66lj2E/s1600/Unity%2BDay_Bully.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><span style="font-family: inherit;"><img border="0" src="http://4.bp.blogspot.com/-CFpTxUHQFGk/VDQd6RNKsWI/AAAAAAAAB_c/3rqYi66lj2E/s1600/Unity%2BDay_Bully.jpg" height="320" width="214" /></span></a></div>
<span style="font-family: Arial, Helvetica, sans-serif;">According to various sources, citing research and survey’s, it
has been reported that as many as 1 in 4 adults will face some form of bullying
in their career.&nbsp; It is important to
point out the differences between constructive criticism, workplace conflict,
and bullying. Workplace bullying focuses on the person rather than the
performance or task being completed by the person. In addition, the person
being targeted feels powerless to stop it. Making the situation worse, is when
the adult being bullied goes to management to report the offense and the abuse
is minimized or discounted altogether. Complicating the issue further is the
difficulty verbalizing what is taking place or being unaware that what is
occurring is bullying, leading to worsening suffering.<o:p></o:p></span><br />
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<br />
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, Helvetica, sans-serif;">What are some forms
of workplace bullying?<o:p></o:p></span></b></div>
<span style="font-family: Arial, Helvetica, sans-serif;">As discussed earlier, workplace bullying can be described as
an extreme pattern where the person is isolated apart from his/her performance
or task. Some examples of <a href="http://www.nxtbook.com/nxtbooks/apf/mentalhealthworks_2012q2/#/6" target="_blank">workplace bullying</a> are: being left-out of
work-related social events, coworkers refusing to help when asked, coworkers
leaving the room when you enter or routinely arriving to meetings late that
when you call them, being yelled at, put down, or disciplined in front of your
coworkers. These are some of the ways that workplace bullying presents, but it
is not an exhaustive list.<o:p></o:p></span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<br />
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, Helvetica, sans-serif;">How workplace
bullying is harmful<o:p></o:p></span></b></div>
<a href="http://2.bp.blogspot.com/-fVus4QiiYXw/VDQjluUKDNI/AAAAAAAAB_s/ugCXCrxfmMM/s1600/Suicide-Prevention-Graphic-FB-Cox.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><span style="font-family: Arial, Helvetica, sans-serif;"><img border="0" src="http://2.bp.blogspot.com/-fVus4QiiYXw/VDQjluUKDNI/AAAAAAAAB_s/ugCXCrxfmMM/s1600/Suicide-Prevention-Graphic-FB-Cox.jpg" height="200" width="200" /></span></a><span style="font-family: Arial, Helvetica, sans-serif;">For individuals who are being bullied in the workplace,
their desire to go into work day after day is diminished and their satisfaction
in their performance and with their employer decreases. <span style="mso-spacerun: yes;">&nbsp;</span>Many reports discuss the loss of productivity
when job satisfaction decreases. Beyond the psychological stress (<a href="http://www.psychiatry.org/mental-health/more-topics/warning-signs-of-mental-illness" target="_blank">depression</a>,
anxiety, <a href="http://www.psychiatry.org/mental-health/people/military" target="_blank">PTSD</a>, etc) – which should not be minimized, stress from bullying can
lead to physical illness such as stroke, heart attacks, chronic fatigue or dissatisfaction
in an person’s personal life – including leading to <a href="http://suicide./">suicide.</a> There are many reports
documenting poor job satisfaction negatively affecting all areas on one’s life.
Feeling accomplished and satisfied in a career can lead to a happier personal
life and vice versa.<o:p></o:p></span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><b style="mso-bidi-font-weight: normal;"></b><br /></span>
<b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, Helvetica, sans-serif;">How to prevent or
deal with workplace bullying<o:p></o:p></span></b><br />
<a href="http://2.bp.blogspot.com/-ksJYEVPF6ng/VDQbadtZGzI/AAAAAAAAB_I/HMukaXNjgBQ/s1600/2014-UD-banner-600px%2Bunite%2Bagainst%2Bbullying.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><span style="font-family: Arial, Helvetica, sans-serif;"><img border="0" src="http://2.bp.blogspot.com/-ksJYEVPF6ng/VDQbadtZGzI/AAAAAAAAB_I/HMukaXNjgBQ/s1600/2014-UD-banner-600px%2Bunite%2Bagainst%2Bbullying.jpg" height="106" width="200" /></span></a><span style="font-family: Arial, Helvetica, sans-serif;">While recognizing or speaking up about workplace bullying
can be a difficult task - it is important not to be silent about bullying experiences,
whether personal attacks or witnessed attacks on colleagues, or isolate from
those that may be able to help. Currently, states are working on anti-bullying
bills to encourage healthy workplace environments, but fostering a workplace
for your coworkers that doesn’t tolerate bullying is key. Many organizations
provide or contract with mental health professionals willing to discuss,
advise, and help an individual navigate the process. It is important to
document your concerns and be specific and concise with the message you are
trying to convey if you feel you are being bullied. Despite how difficult it
may be, it is important to approach the bully or go to your supervisor with a
calm demeanor and discuss your concerns rationally. Lastly, it is important to
have an open mind about the situation. Sometimes it may be that the “bully”
does not realize how his/her actions have affected you. Approaching them, or
the situation, calmly will provide an environment for understanding and
increase the probability for change. <o:p></o:p></span><br />
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<br />
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<o:p><span style="font-family: Arial, Helvetica, sans-serif;"><a href="http://apahealthyminds.blogspot.com/2011/12/how-to-bully-proof-kids.html" target="_blank">How to "Bully-Proof " Kids </a></span></o:p></div>
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</script>American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-70348337061376765412014-08-22T14:58:00.003-04:002015-01-23T15:03:39.172-05:00Williams’ death reminds us that a patient’s relief might be a warning sign<br />
<br />
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<span lang="EN" style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 9pt; mso-ansi-language: EN; mso-fareast-font-family: &quot;Times New Roman&quot;;">By
H. Steven Moffic, MD <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 10pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span lang="EN" style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 9pt; mso-ansi-language: EN; mso-fareast-font-family: &quot;Times New Roman&quot;;">One
of my favorite movie moments is when Robin Williams signs on as an edgy D.J. by
exclaiming "Good Morning, Vietnam" from the 1987 movie of the same name.
Sometimes, I played the audio over and over, as if it could promise a good day.
As he did so often, he found a way to not only lighten the sadness, but to do
it in such a way that might be constructively critical.<o:p></o:p></span></div>
<span lang="EN" style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 9pt; mso-ansi-language: EN; mso-fareast-font-family: &quot;Times New Roman&quot;;">Surely,
the real life mornings were not often happy ones, as so many of our troops died
or ended up with <a href="http://www.psychiatry.org/ptsd" target="_blank">post-traumatic stress disorder (PTSD)</a> from that war. It is a
lesson we are still learning, so that movie and his role is worth seeing again
soon.</span><br />
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<span lang="EN" style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 9pt; mso-ansi-language: EN; mso-fareast-font-family: &quot;Times New Roman&quot;;"><br />Now,
after his reported suicide, that good morning seems more like a final good
night.<o:p></o:p></span></div>
<span lang="EN" style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 9pt; mso-ansi-language: EN; mso-fareast-font-family: &quot;Times New Roman&quot;;">Although
he is probably best known for his manic comedy, he also played many serious
roles. Most ironically now, he won an academy award in 1997 for playing an
empathic therapist in the film “Good Will Hunting.”<o:p></o:p></span><br />
<span lang="EN" style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 9pt; mso-ansi-language: EN; mso-fareast-font-family: &quot;Times New Roman&quot;;">Indeed,
beloved entertainers like Robin Williams have a therapeutic role of sorts for
society in the sense that they provide some relief—even if briefly—for the
grief and stress of everyday life. For playing that societal role, such people
become a repository for our hopes, dreams and demons. As we know for so many
famous entertainers, it is not easy for them to have a successful private
life—a private life that the public also tries to invade, as if they were
related to us.<o:p></o:p></span><br />
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 10pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span lang="EN" style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 9pt; mso-ansi-language: EN; mso-fareast-font-family: &quot;Times New Roman&quot;;">What
we do know publicly is that Williams suffered from chronic <a href="http://www.psychiatry.org/depression" target="_blank">depression</a> and
intermittent <a href="http://www.psychiatry.org/addiction" target="_blank">substance abuse</a>. It is reported that he received treatment,
including entering rehab just last month. Obviously, money to get the best
treatment was not an issue, though how good the treatment was will remain
unknown. We do know, however, that wealthy VIPs often receive treatment just as
poor as low-income folks without resources. We also know that occasionally
depression is a terminal illness, though that ending is not predictable.<o:p></o:p></span></div>
<span lang="EN" style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 9pt; mso-ansi-language: EN; mso-fareast-font-family: &quot;Times New Roman&quot;;">Beyond
the public information, and despite the understandable curiosity, this is not
the time, nor should it ever be the time, to speculate about his diagnosis and
reasons for committing suicide. In fact, the so-called "Goldwater
Rule," called that for the inappropriate professional speculation about
presidential candidate Barry Goldwater, ethically prohibits such speculations
on the part of psychiatrists like myself.<o:p></o:p></span><br />
<span lang="EN" style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 9pt; mso-ansi-language: EN; mso-fareast-font-family: &quot;Times New Roman&quot;;"><br />Given
this professional ethical principle, as well as the family's request for
privacy, is there anything we can still learn from this apparent tragedy? The
most intriguing detail that caught my attention was his last tweet and
Instagram on July 31. Reportedly, he had wished his daughter a happy 25th
birthday.<o:p></o:p></span><br />
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 10pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span lang="EN" style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 9pt; mso-ansi-language: EN; mso-fareast-font-family: &quot;Times New Roman&quot;;">Why
might this positive communication be of importance to us?<o:p></o:p></span></div>
<span lang="EN" style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 9pt; mso-ansi-language: EN; mso-fareast-font-family: &quot;Times New Roman&quot;;">It
reminded me of the only patient I ever had who committed suicide, long ago,
when I was a resident in training. In the second session, the depression of
this elderly man seemed to be less severe, but after that session he walked
into Lake Michigan and drown. In the psychological autopsy, I never forgot the
warning that when a depressed patient starts to seem better, they actually can
be at higher risk for suicide.<o:p></o:p></span><br />
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 10pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span lang="EN" style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 9pt; mso-ansi-language: EN; mso-fareast-font-family: &quot;Times New Roman&quot;;">Risky
time</span></b><span lang="EN" style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 9pt; mso-ansi-language: EN; mso-fareast-font-family: &quot;Times New Roman&quot;;"><o:p></o:p></span></div>
<span lang="EN" style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 9pt; mso-ansi-language: EN; mso-fareast-font-family: &quot;Times New Roman&quot;;">Why
is that time of apparent improvement a risky time? The person can have more
energy, then plan and complete a suicide. They may also feel relief at their
decision, causing others to paradoxically feel relief. That is one of the
reasons why it is so common to hear of the genuine surprise that the suicide
occurred, as the person seemed to be happier.<o:p></o:p></span><br />
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 10pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span lang="EN" style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 9pt; mso-ansi-language: EN; mso-fareast-font-family: &quot;Times New Roman&quot;;">What
this means, not only for professionals, but for the public, is not to take at
face value if a depressed person seems better. Be sure there is a sound
explanation for the apparent improvement.&nbsp;<o:p></o:p></span></div>
<span lang="EN" style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 9pt; mso-ansi-language: EN; mso-fareast-font-family: &quot;Times New Roman&quot;;">Our
only consolation must be that entertainers like Robin Williams keep on living
in the form of their life’s work, like the movie “Good Morning, Vietnam,” that
is so ubiquitously available nowadays. Even so, it would not be surprising if
at the times we laugh once again at Robin William's humor, that the laughter
will also be accompanied by some tears of grief.<o:p></o:p></span><br />
<br />
<br />
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<span style="font-family: Calibri;">Bio <o:p></o:p></span></div>
<span style="font-family: Calibri;">H. Steven Moffic, MD, is a Life Fellow of the APA.&nbsp;</span><span style="font-family: Calibri;">Currently, he blogs regularly for Psychiatric Times, Behavioral
Healthcare, and The Hastings Center's Over 65.</span><br />
<span style="font-family: Calibri;"><br /></span>
<span style="font-family: Calibri;">This blog was originally published in <a href="http://www.behavioral.net/" target="_blank">Behavioral Healthcare</a>.</span>
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</script>American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-21258051165306637922014-08-19T13:50:00.000-04:002015-01-23T15:20:58.940-05:00Spreading Hope!<b style="mso-bidi-font-weight: normal;"><span style="font-family: Calibri;">By Matt Goldenberg
D.O.</span></b><br />
<span style="font-family: Calibri;"><o:p><span style="font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; font-size: 12pt; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;">@docgoldenberg&nbsp;</span></o:p></span><br />
<span style="font-family: Calibri;">“You treat a disease, you win, you lose. You treat a person,
I guarantee you, you'll win, no matter what the outcome.”&nbsp;<o:p></o:p></span><br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="http://3.bp.blogspot.com/-ppcfs_aHuZA/U_N7QXfNHzI/AAAAAAAAB4s/l-D78RZGzi0/s1600/patch-adams-553248l.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://3.bp.blogspot.com/-ppcfs_aHuZA/U_N7QXfNHzI/AAAAAAAAB4s/l-D78RZGzi0/s1600/patch-adams-553248l.jpg" height="200" width="133" /></a></div>
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<span style="font-family: Calibri;">I whole-heartedly agree with that statement. However, I
cannot take credit for those words. Those are the words of Robin Williams, or
more specifically, the words of his character in Patch Adams.<br />
<br />
I want to discuss the disease called depression. I will start by first
discussing the diagnosis and the signs and symptoms of depression. I will then
follow up with my thoughts on the various treatment options for depression and
the strategies I employ with my patients to improve their outcomes. None of my
thoughts and suggestions should serve in place of a formal consultation with a
mental healthcare provider. However, I hope shedding light on mental health
diagnoses like depression will lift the veil and social stigma on these chronic
diseases that impact so many people. <br />
<br />
Psychiatry has come a long way in the last decade. This is a time of continued
discovery and increasing public awareness. The leaders of our professional
organization, the </span><a href="http://www.psych.org/File%20Library/Advocacy%20and%20Newsroom/Presidents%20Messages/Summergrad-2014-AM-Opening-Speech.pdf" target="_blank"><span style="color: blue; font-family: Calibri;">American Psychiatric Association (APA), have suggested that we
as mental health professionals are under a microscope</span></a><span style="font-family: Calibri;">. I agree that we are
and I also strongly believe that we are up for the challenge. School shootings
and celebrity suicides and overdoses have increasingly put a focus on mental
health. Psychiatry has significantly improved the outcomes, treatment options
and the prognosis of patients with mental illness. However, we still are unable
to decrease the prevalence of the diseases we treat or prevent them. We know that
the brain changes during an episode of depression and our treatments help it to
return to normal (see the image below). Although we are getting closer, we
still currently do not have widely accessible blood or imaging tests that can
confirm our diagnosis or localize the area of disease.</span><span style="font-family: Calibri;"><a href="http://3.bp.blogspot.com/-JTw9KBL6Sp4/U_N0hbz4uuI/AAAAAAAAB4U/qQB202mqjRE/s1600/Manbrainimgae.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://3.bp.blogspot.com/-JTw9KBL6Sp4/U_N0hbz4uuI/AAAAAAAAB4U/qQB202mqjRE/s1600/Manbrainimgae.jpg" height="160" width="200" /></a></span></div>
<span style="font-family: Calibri;"></span><br />
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: Calibri;">I can say with certainty, however, we are able to accurately
diagnose patients. We are able to identify medications, psychotherapies and
other treatments that patients with a specific diagnosis or cluster of signs and
symptoms often benefit from. There is strong evidence that our treatments
decrease symptomatology and disability and improve quality of life, clinical
outcomes and a patient’s prognosis.</span><br />
<br />
<span style="font-family: Calibri;">Psychiatrists are trained to view the patient as a “whole person”. Psychiatry
is a field of medicine whose assessment by definition includes all of the
biological, psychological and social aspects of a patient’s life. We listen for
the psychological and social factors that can contribute to disease.
Oftentimes, the “whole story” can be more telling than only focusing on
specific symptoms of a given disease. There is a saying, throughout all fields
of medicine, that “most patients have not read the textbook.” In other words,
patients usually do not present exactly as the textbook says they should.
Stress and psychological factors can mimic chest pain, shortness of breath,
gastrointestinal problems and a whole host of other diseases. If we do not step
back and get the whole story, we can miss the root cause or the exacerbating
factors of many manageable diseases which are of the mind.</span><br />
<br />
<span style="font-family: Calibri;">Many of the diseases we treat, such as depression, are chronic illnesses which
require lifelong treatment. Our treatments can improve a patient’s mental
health and coping skills and decrease their symptomatology and substance use.
We know through decades of research that these are modifiable risk factors for
suicide. Therefore, Psychiatrists have the training and tools necessary to
decrease a patient’s risk of attempting suicide. Our treatments have the
potential to not only significantly improve the lives of our patients, but also
the lives of their families and everyone who comes into contact with them.
Anyone who tells you otherwise is misleading, misinformed or both.</span></div>
<span style="font-family: Calibri;">
</span>
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: Calibri;"><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 12pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: &quot;Times New Roman&quot;; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">
<span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; font-size: 11pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: &quot;Times New Roman&quot;; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">I
hope this information and the blogs to follow will give you hope. Mental
illness can include symptoms which can be devastating and complications which
can be <a href="http://psychiatry.org/suicide" target="_blank"><span style="color: blue;">life-threatening</span></a>.
However, it is important to state again, these are treatable diseases. If you
or someone you know, would like to talk to someone, call your primary care
doctor or your insurance company for a referral to a Psychiatrist. A true
multi-disciplinary team also includes therapists, psychologists, nurses and
social workers. You are never alone. You can call the national suicide helpline
24 hours a day, seven days a week (1-800-273-TALK (8255) or visit <a href="http://www.suicidepreventionlifeline.org/"><span style="color: blue;">www.suicidepreventionlifeline.org</span></a>).
There are also local crisis lines likely available in your area and are an
internet search away. If you are ever feeling unsafe, or fearing for the safety
of a loved one, you can call 911 or go to the nearest emergency department.</span></span></span></div>
<span style="font-family: Calibri;">
</span><span style="font-family: Calibri;">It is time for everyone to understand that there is no shame in getting help
for depression, much as there is no shame in getting help with diabetes or high
cholesterol. Even if you have never suffered from depression, there is
a lot you can learn. <br />
</span><br />
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: Calibri;"><a href="http://3.bp.blogspot.com/-FlhmhMaxeC4/U_N03Bv1eaI/AAAAAAAAB4c/qUTj-3_RIAQ/s1600/Depressed_NotDepressed%2Bbrain%2Bimage.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://3.bp.blogspot.com/-FlhmhMaxeC4/U_N03Bv1eaI/AAAAAAAAB4c/qUTj-3_RIAQ/s1600/Depressed_NotDepressed%2Bbrain%2Bimage.jpg" height="200" width="200" /></a></span></div>
<span style="font-family: Calibri;">
</span><span style="font-family: Calibri;">
Together we can raise awareness and spread truth and hope. I know that if we
spread knowledge, and ignore the misinformation, we will overcome the
complacency and ignorance that is so pervasive today. That is how we can best
honor those we have lost. That is how we can best prevent the next death from
mental illness and addiction. <o:p></o:p></span><br />
<br />
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
</div>
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</script>American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-48566139355606101202014-08-05T10:32:00.000-04:002015-01-23T15:28:04.700-05:00How does your primary care doctor coordinate with your psychiatrist?<b style="mso-bidi-font-weight: normal;"><span style="font-family: Cambria;">By Pierre
Gingerich-Boberg, Medical Student<o:p></o:p></span></b><br />
<span style="font-family: Cambria;"><b style="mso-bidi-font-weight: normal;">Reviewed by Claudia
Reardon, MD</b><o:p></o:p></span><br />
<i style="mso-bidi-font-style: normal;"><span style="font-family: Cambria;"></span></i><br />
<i style="mso-bidi-font-style: normal;"><span style="font-family: Cambria;">I’m stuck in behaviors
that are making me unhealthy.<span style="mso-spacerun: yes;">&nbsp; </span>My smoking
makes my asthma worse, and I don’t want to end up with emphysema like my dad.<span style="mso-spacerun: yes;">&nbsp; </span>I smoke when I’m anxious, and my finances, my
teenager, my boss, and my increasing weight all make me anxious.<span style="mso-spacerun: yes;">&nbsp; </span>Now to top it off, my chronic headaches are
getting worse.<span style="mso-spacerun: yes;">&nbsp; </span>My problems are physical,
but I know they’re also mental.<span style="mso-spacerun: yes;">&nbsp; </span>But the
idea of seeing a psychiatrist makes me even more anxious!<span style="mso-spacerun: yes;">&nbsp; </span>What should I do?<o:p></o:p></span></i><br />
<br />
<a href="http://2.bp.blogspot.com/-FggZ9c3a9Qw/U9-tCQd_SkI/AAAAAAAABq0/H9pxBMXrmRg/s1600/IC+graphic+part+1.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-FggZ9c3a9Qw/U9-tCQd_SkI/AAAAAAAABq0/H9pxBMXrmRg/s1600/IC+graphic+part+1.jpg" height="118" width="200" /></a><span style="font-family: Cambria;">Patients need primary care doctors who can comprehensively
address the varied aspects of their physical and mental health. Health systems
are starting to recognize that multi-disciplinary teams (sometimes called <i style="mso-bidi-font-style: normal;">patient-centered medical homes</i>) can be
an effective way to provide </span><a href="http://www.psychiatry.org/practice/professional-interests/integrated-care"><span style="color: blue; font-family: Cambria;">integrated
care. </span></a><span style="font-family: Cambria;"><span style="mso-spacerun: yes;">&nbsp;</span>How might this look for our example
patient?<o:p></o:p></span><br />
<br />
<div class="MsoNormal" style="margin: 0in 0in 0pt;">
<span style="font-family: Cambria;">First, it’s worth noting that traditional </span><a href="http://integrationacademy.ahrq.gov/lexicon"><span style="color: blue; font-family: Cambria;">primary care</span></a><span style="font-family: Cambria;"> doctors
already spend a lot of effort helping patients with a wide spectrum of behavior
issues.<span style="mso-spacerun: yes;">&nbsp; </span>We saw this for our example patient.
<span style="mso-spacerun: yes;">&nbsp;</span>Her anxiety is an example of a <i style="mso-bidi-font-style: normal;">classic mental health problem—</i>others
might be depression, panic attacks, and addictions. Primary care docs refer some
of these patients to psychiatrists, but primary care docs are treating the
majority directly. <span style="mso-spacerun: yes;">&nbsp;</span>Our patient’s
headaches are likely a <i style="mso-bidi-font-style: normal;">functional
ailment. </i>Like irritable bowel syndrome and general aches and pains,
headaches are real problems that often defy simple solutions.<span style="mso-spacerun: yes;">&nbsp; </span>Standard treatments focus on limiting symptoms
while helping patients cope with the stressors and psychological distress that often
contribute.<span style="mso-spacerun: yes;">&nbsp; </span>Finally, our patient faces
problems with <i style="mso-bidi-font-style: normal;">health-related behaviors </i>including
tobacco use, diet, and stress management.<span style="mso-spacerun: yes;">&nbsp;
</span>These and other common behaviors are hugely important for the development
of chronic diseases. <span style="mso-spacerun: yes;">&nbsp;</span><o:p></o:p></span></div>
<br />
<a href="http://3.bp.blogspot.com/-MY97MSf8WjA/U9-s2hlY6KI/AAAAAAAABqs/umiIxIe9dCI/s1600/IC+graphic+part+5.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://3.bp.blogspot.com/-MY97MSf8WjA/U9-s2hlY6KI/AAAAAAAABqs/umiIxIe9dCI/s1600/IC+graphic+part+5.jpg" height="192" width="320" /></a><span style="font-family: Cambria;">Our patient’s picture might seem complex, but primary care
doctors face such complexity (and more) every day! Frankly, patients often are
dealing with too much for their doctors to address optimally in a 15-20 minute
time slot. One approach is to triage—to ask what’s treatable and doable, and
what can wait until the next appointment. <span style="mso-bidi-font-family: &quot;Times New Roman&quot;; mso-fareast-font-family: &quot;Times New Roman&quot;;">The limited time
available for counseling tends to push primary care doctors toward relying on
treatment with psych meds.</span> A second approach is to refer the patient to
a psychiatrist.<span style="mso-spacerun: yes;">&nbsp; </span>But psychiatrists in
many communities are spread too thin, so patients often wait weeks or months
for an appointment. Then there’s stigma--our example patient’s anxiety around
psychiatric care is actually pretty typical.<span style="mso-spacerun: yes;">&nbsp;
</span>This helps push up no-show rates for first visits with a psychiatrist to
30 or 40%.<span style="mso-spacerun: yes;">&nbsp; </span>It’s no wonder that careful
studies show that only a fraction of the mental health problems in our
communities are ever diagnosed, and fewer still are adequately treated.<o:p></o:p></span><br />
<br />
<div class="MsoNormal" style="margin: 0in 0in 0pt;">
<span style="font-family: Cambria;">A third option returns us to the </span><a href="http://www.medicaid.gov/State-Resource-Center/Medicaid-State-Technical-Assistance/Health-Homes-Technical-Assistance/Guide-to-Health-Homes-Design-and-Implementation.html"><span style="color: blue; font-family: Cambria;">medical
home</span></a><span style="font-family: Cambria;"> concept. <span style="mso-spacerun: yes;">&nbsp;</span>At the VA and increasingly
in federally qualified health centers (FQHCs), mental health services are being
brought into the primary care setting.<span style="mso-spacerun: yes;">&nbsp;
</span>Here, <i style="mso-bidi-font-style: normal;"><a href="http://www.hipxchange.org/Access"><span style="color: blue;">behavioral health consultants</span></a></i>
(BHCs) share space with primary care doctors.<span style="mso-spacerun: yes;">&nbsp;
</span>These are generally psychologists or social workers, that is,
non-physicians. BHCs’ schedules are intentionally left mostly open, so that they’re
available to see patients immediately after a non-threatening ‘warm handoff’
from the primary care doc.<span style="mso-spacerun: yes;">&nbsp; </span>The BHC can offer
expert counseling for the patient, and advise the primary care provider on
diagnosis and treatment.<span style="mso-spacerun: yes;">&nbsp; </span>BHCs arrange
for a small subset of their patients to get a subsequent visit with a psychiatrist
(a specialist physician), who is also in-house.<span style="mso-spacerun: yes;">&nbsp;
</span><span style="mso-spacerun: yes;">&nbsp;</span>All the BHC patients get
systematic evaluation and follow-up by phone or with visits to make sure their
needs don’t fall through the cracks.<o:p></o:p></span></div>
<br />
<iframe allowfullscreen="" frameborder="0" height="160" src="//www.youtube.com/embed/Z8Kx0GxSle0?list=PLf3_-c0tpWquEz-UdYwSWBTBIJwwKfARC" width="280"></iframe>
<br />
<span style="font-family: Cambria;">When a behavioral health consultation system is in place,
problems of waiting times, missed appointments, and incomplete records are
eliminated for most behavioral health visits.<span style="mso-spacerun: yes;">&nbsp;
</span>Primary care docs have more time to focus on medical issues, while
getting the expert consultation they need to optimize behavioral health care
for their patients. Finally, because most behavioral issues can be addressed efficiently
by BHCs, specialty psychiatrists are not so swamped, and waiting times can be
greatly shortened for the small group of patients needing psychiatric care beyond
what can be managed in the primary care setting. </span>
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</script>American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-50565515248685292582014-07-10T15:31:00.000-04:002015-01-26T09:56:56.359-05:00Diversity Mental Health Month: Why It is Needed and How It Came to Be<br />
<h4 class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt;">
By Steve Koh, MD, MPH, MBA<o:p></o:p></h4>
<span style="font-family: Calibri;">July of 2014 is the very first APA Diversity Mental Health Month. This
emphasis on mental health needs of diverse populations is much needed. While we
have diversity oriented month observances for specific population groups like
the Black History Month (February), National Women’s History Month (March),
Asian Pacific American Heritage Month (May), Gay and Lesbian Pride Month
(June), American Indian Heritage Month (August), and Hispanic Heritage Month
(September), we have not had a dedicated month more broadly addressing diverse
populations and mental health issues. <o:p></o:p></span><br />
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt;">
<span style="font-family: Calibri;">I cannot overemphasize the importance of this month. For the first
time, together, we will bring attention to the unique and challenging needs of
the diverse populations with mental illness and substance use disorders, work
to decrease mental health disparities, and engage with diverse populations to
help promote and grow future mental health champions in the communities.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt;">
<a href="http://4.bp.blogspot.com/-MQmzo8ohZPE/U8anJCzVQbI/AAAAAAAABlM/tDzHEoM9WCA/s1600/diversity.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-MQmzo8ohZPE/U8anJCzVQbI/AAAAAAAABlM/tDzHEoM9WCA/s1600/diversity.png" height="320" width="194" /></a><span style="font-family: Calibri;">The concept for Diversity Mental Health Month came from a group of
participants in APA’s Minority Fellowship program.<span style="mso-spacerun: yes;">&nbsp; </span>The program’s goal is to eliminate racial and
ethnic disparities in mental health and substance abuse care by providing
specialized training and mentorship. The fellowship fosters those with diverse
backgrounds who have chosen to become physicians specializing in mental health
and to do this work with the diverse populations. <span style="mso-spacerun: yes;">&nbsp;</span><br />
<br />
But what happens when we go home? What then? We felt that it was easy to get
lost when we left our APA meetings in Washington DC. How do we galvanize our
colleagues at home to look at the importance of minority mental health issues?
To recognize the stigma of being an ethnic and cultural minority and also
suffering mental illness? To understand that many minority students do not
consider going into field of medicine let alone mental health profession? To
appreciate the importance of cultural competency and humility in working with
diverse patient population?<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt;">
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</v:shape><![endif]--><!--[if !vml]--><!--[endif]--><span style="font-family: Calibri;">Without
involvement a coordinated effort by the APA, it was our belief that while we
personally benefited from the fellowship experience, our impact would be
limited. There needed to be a designated time for all of APA to bring attention
to this important patient population.<span style="mso-spacerun: yes;">&nbsp; </span>So
the idea was born to create a Diversity Mental Health Month. The APA Assembly asked
APA staff to help create a month designated to minority mental health issues
and for the APA to actively promote the month. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt;">
<span style="font-family: Calibri;">I hope that others are excited about this new endeavor of the APA as I
am. The challenges are great but together we can bring the needed attention to
this area of our profession. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt;">
<span style="font-family: Calibri;">Many resources, including an infographic with basic data on mental
health disparities, and brochures and fact sheets on specific populations,
suggested activities, video messages, and more, are available at </span><a href="http://www.psychiatry.org/diversity-month"><span style="color: blue; font-family: Calibri;">www.psychiatry.org/diversity-month</span></a><span style="font-family: Calibri;">.<o:p></o:p></span></div>
<br />
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</div>
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</div>
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</div>
American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-78831117321625482892014-07-02T15:53:00.001-04:002015-01-23T15:31:59.621-05:00Depression & Cancer<span style="font-family: Cambria;">By <a href="http://www.psychiatry.org/mental-health/healthy-minds-blog-contributors" target="_blank">Brad Zehring, DO</a> </span><a href="https://twitter.com/DrZehringDO" style="font-family: Cambria;" target="_blank">@DrZehringDO</a><br />
<div class="MsoNormal" style="margin: 0in 0in 0pt;">
</div>
<span style="font-family: Cambria;"><i><br /></i></span>
<span style="font-family: Cambria;"><i>
</i></span><span style="font-family: Cambria;"><i>“Cancer can take away all of my physical abilities. It
cannot touch my mind, it cannot touch my heart, and it cannot touch my
soul”<span style="mso-spacerun: yes;">&nbsp; </span>- Jim Valvano</i><o:p></o:p></span><br />
<br />
<div class="MsoNormal" style="margin: 0in 0in 0pt;">
<span class="bqquotelink"><span style="color: black; mso-bidi-font-family: &quot;Times New Roman&quot;; mso-fareast-font-family: &quot;Times New Roman&quot;;"><span style="font-family: Cambria;">But, what
happens when it does? <o:p></o:p></span></span></span></div>
<br />
<a href="http://www.psychiatry.org/mental-health/depression"><span style="color: blue; font-family: Cambria;">Depression</span></a><span style="font-family: Cambria;">
is a multifactorial disorder that requires acknowledgement of the biological,
psychological, and social aspects of a person’s life. Professionals in the
mental health community describe this as the biopsychosocial model. It provides
an understanding of the factors influencing a person’s mental and physical
state of being. <o:p></o:p></span><br />
<br />
<div class="MsoNormal" style="margin: 0in 0in 0pt;">
<a href="http://1.bp.blogspot.com/-zngi2wsEFAo/U7RiITSCEUI/AAAAAAAABA4/L3uegd-o8lI/s1600/DSM5+icon.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://1.bp.blogspot.com/-zngi2wsEFAo/U7RiITSCEUI/AAAAAAAABA4/L3uegd-o8lI/s1600/DSM5+icon.jpg" /></a><span style="font-family: Cambria;">When mental health professionals talk about depression they
often do so in regards to Major Depressive Disorder (MDD). According to <em>DSM 5</em>
(Diagnostic and Statistical Manual of Mental Disorders), 5 out of 9 criteria
are needed to diagnose MDD. It requires a depressed mood or anhedonia (lack of
enjoying what was previously enjoyed) for greater than 2 weeks including:
disturbances in sleep, guilty/hopeless/worthless feelings, poor concentration,
low energy, changes in appetite (weight loss or weight gain), psychomotor
agitation or retardation, and suicidal ideation.</span></div>
<div class="MsoNormal" style="margin: 0in 0in 0pt;">
</div>
<span style="font-family: Cambria;">Depression affects your entire body. But, the physical
aspects of depression are often overlooked. It is common for people with
depression to experience weight changes, digestive problems, headaches, back
pain, muscle and joint pain, and disruptions in sleep cycle. Many symptoms that
are present in cancer.<o:p></o:p></span><br />
<br />
<div class="MsoNormal" style="margin: 0in 0in 0pt;">
<span style="font-family: Cambria;">Depression has been linked with many health problems,
including cancer. Cancer is a heavy word. The enormity of the word brings many
images to the forefront of our imagination: radiation, chemotherapy, losing
hair, sickness, weakness, and death - among others. There is so much symptom
overlap between cancer and depression it can be hard to recognize the etiology
of the symptoms.<o:p></o:p></span></div>
<br />
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<a href="http://2.bp.blogspot.com/-g6SsT49IykI/U7Ri7sCoSsI/AAAAAAAABBI/H5YBmUZYsNQ/s1600/doctor+prescribing+feature.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-g6SsT49IykI/U7Ri7sCoSsI/AAAAAAAABBI/H5YBmUZYsNQ/s1600/doctor+prescribing+feature.jpg" height="93" width="200" /></a></div>
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<span style="font-family: Cambria;">It is important that health care professionals, family
members, and other </span><a href="http://www.psychiatry.org/mental-health/key-topics/caregivers"><span style="color: blue; font-family: Cambria;">caretakers</span></a><span style="font-family: Cambria;">
are vigilant with a person’s mental well being after they are diagnosed with
cancer. Even if a person has never experienced depression previously, their
risk of depression is increased when they find out they have cancer. Research
shows that the incidence of depression increases proportionately with the
cancer’s progression. It is believed those with depression have increased
likelihood of depression because of increased immune response (cytokines)
within the body. <o:p></o:p></span></div>
<br />
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<span style="font-family: Cambria;">It is important not to assume that someone with cancer has
an appropriate depressed mood due to his or her circumstances.<span style="mso-spacerun: yes;">&nbsp; </span>This is why it is important to screen for
depression in those diagnosed with cancer. Screening for depression can help
“tease out” symptoms related to depression and symptoms related to the cancer. Treating
depression in patients with cancer can help them focus on their treatment and
have the motivation to do everything needed to possibly achieve remission.
Proper treatment gives them the ability to focus on their future. Cancer alone
is enough, but when combined with untreated depression the results can be
deadly. <o:p></o:p></span></div>
<br />
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<a href="http://3.bp.blogspot.com/-zECmY9pF2mU/U7RiW2kaJwI/AAAAAAAABBA/TlTW7VbCZk8/s1600/Depression%23C-KS76864-getty.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://3.bp.blogspot.com/-zECmY9pF2mU/U7RiW2kaJwI/AAAAAAAABBA/TlTW7VbCZk8/s1600/Depression%23C-KS76864-getty.jpg" /></a><span style="font-family: Cambria;">After recognizing depression in someone with cancer, there
are ways to treat depression in parallel with cancer treatment. There are two
forms of treatment. One involves medication and the other involves
psychotherapy, or talk therapy. The typical medications for depression are
antidepressants like Selective Serotonin Reuptake Inhibitors (SSRI) and
Serotonin and Norepinephrine Reuptake Inhibitors (SNRI). These medications have
been around for a long time and are generally well tolerated. They take
anywhere from 2-6 weeks for clinical efficacy. These medications should be
monitored with cancer treatment, as there can be drug interactions and side
effects that may not be present in someone taking these medications without
cancer. In addition to medications, psychotherapy can be effective. More
specifically, Cognitive Behavioral Therapy (CBT) can help people change their
negative thoughts about cancer and their future. For the most efficacious
treatment a combination of both should be implemented. <o:p></o:p></span></div>
<br />
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<span style="font-family: Cambria;">Cancer is a serious illness and a well-developed
multi-disciplinary approach is necessary to best treat the patient. Cancer can
cause a lot of different disturbances in physical and mental health. It is
important to have health professionals, like </span><a href="http://www.psychiatry.org/mental-health/more-topics/what-is-a-psychiatrist"><span style="color: blue; font-family: Cambria;">psychiatrists</span></a><span style="font-family: Cambria;">
and psychologists, part of the treatment team to ensure proper treatment of the
whole patient. <o:p></o:p></span></div>
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</script>American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-60742179237725545412014-05-28T15:54:00.002-04:002015-01-23T15:35:23.525-05:00Telemedicine, Here I Come!<a href="http://1.bp.blogspot.com/-7c9B_QqdA4I/U4Y2For80wI/AAAAAAAABAI/tEYfHGZEC_A/s1600/telehealth.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://1.bp.blogspot.com/-7c9B_QqdA4I/U4Y2For80wI/AAAAAAAABAI/tEYfHGZEC_A/s1600/telehealth.png" /></a><br />
<div class="MsoNormal" style="background: white; margin: 0in 0in 0pt;">
<span style="color: black; font-family: Arial, Helvetica, sans-serif;"><strong>By <a href="http://www.psychiatry.org/mental-health/healthy-minds-blog-contributors" target="_blank">Hind Benjelloun, MD</a>&nbsp;</strong></span><b><a href="https://twitter.com/hbenjelloun" target="_blank"><span style="font-family: Arial, Helvetica, sans-serif;">@hbenjelloun</span>&nbsp;</a></b><br />
<br />
<span style="font-family: Arial, Helvetica, sans-serif;">My decision to
pursue a career in telemedicine was a long process. I had a comfortable, stable
clinical position at a highly regarded academic center in a lively city. But I
kept wondering if my career needed a boost. I found myself thinking,&nbsp;</span><i style="font-family: Arial, Helvetica, sans-serif;">career
development takes risk</i><span style="font-family: Arial, Helvetica, sans-serif;">. Medicine is an ever-changing and growing field. I
felt that I had to embrace some changes myself if I wanted to keep up.</span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif;">Telemedicine is a relatively new&nbsp;discipline. The idea of
incorporating health care with technology, specifically the web, may have some
rolling their eyes or shaking their heads. But, simply put, it is the future of
healthcare; and it is certainly getting the buzz these days.</span></div>
<div class="MsoNormal" style="background: white; margin: 0in 0in 0pt;">
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif;">The </span><a href="http://www.americantelemed.org/home" style="font-family: Arial, Helvetica, sans-serif;" target="_blank">American Telemedicine Association</a><span style="font-family: Arial, Helvetica, sans-serif;"> is rapidly growing and developing
its services and its role in healthcare. Many medical and scientific
organizations are recognizing the importance of the discipline as well. You can
see it reflected in the number of publications, conference seminars, and
available CME. Tech gurus are predicting that the recent acquisition of Oculus
by Facebook will be a game changer in the tech industry and will further grow
telemedicine’s influence.</span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif;">So I took the plunge into a field in its infancy. I went for it.
&nbsp;Telepsychiatry! After almost ten years at Georgetown University Medical
Center, I drastically shifted gears to pursue a full time career in crisis
telepsychiatry.</span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif;">In this career change, I have been labeled a pioneer among colleagues
and friends. It feels wonderful to immerse myself in such an innovative
healthcare movement. My healthy narcissism embraces it and it strengthens my
confidence in what some may call a risky career decision. Today, telepsychiatry
is revolutionary in the way it </span><a href="http://www.psychiatry.org/advocacy--newsroom/advocacy/government-relations/improving-access-to-mental-health-treatment" style="background-color: transparent; font-family: Arial, Helvetica, sans-serif;" target="_blank">enhances access to care</a><span style="font-family: Arial, Helvetica, sans-serif;">. And although right now
telepsychiatry is primarily seen as a means of engaging the rural patient
population, it will progress in the medical community as a future medical norm.
The evidence is growing and continues to demonstrate the boom of telemedicine
and its success.</span></div>
<div class="MsoNormal" style="background: white; margin: 0in 0in 0pt;">
<a href="http://3.bp.blogspot.com/-3enF6JuyXyo/U4Y3FvGqedI/AAAAAAAABAQ/oQSxCkFeywE/s1600/telepsychiatry.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><span style="font-family: Arial, Helvetica, sans-serif;"><img border="0" src="http://3.bp.blogspot.com/-3enF6JuyXyo/U4Y3FvGqedI/AAAAAAAABAQ/oQSxCkFeywE/s1600/telepsychiatry.png" height="111" width="200" /></span></a><span style="font-family: Arial, Helvetica, sans-serif;"><span style="background-color: white; background-position: initial initial; background-repeat: initial initial; color: black;">Still, taking the leap into telepsychiatry had its downsides.</span></span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif;">Because of its youth, telemedicine lacks a number of accessible mentors
who can guide the process. There are few clinicians who have an “institutional”
knowledge of telemedicine to share. This means that other than the anecdotal
accounts that you may read in a journal or blog post about what it’s like to
venture into the world of telemedicine as a provider, there aren’t many
reputable sources to turn to. &nbsp;I had trouble knowing what to expect.</span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif;">I started working with InSight, a national telepsychiatry provider
company earlier this year. As a crisis telepsychiatrist with InSight, I have
the ability to seamlessly transition between seeing patients at multiple
hospitals in multiple states back to back. Today, I love my job. But the
legislative hurdles I had to jump through to get going were a major headache.</span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif;">I was completely committed to offering services right away when I made
the decision to start practicing telepsychiatry. I was ready to go. But I had
no idea what kind of challenges I would encounter as I attempted to receive
licensing from medical boards that all work independently of each other.</span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif;">After the first hurdle of becoming licensed, I thought I had passed the finish
line. But to my surprise, I was back to waiting on privileges from hospitals
that were scrutinizing my immunization records and testing my knowledge of
their fire code. This all seems so frivolous and a waste of time, effort and
money. Didn’t they understand that I would be seeing patients&nbsp;</span><i style="background-color: transparent; font-family: Arial, Helvetica, sans-serif;">remotely?</i><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif;">When I finally began working with a regular schedule, I found myself
asking, why did it take so long for me to be able to actually see patients and
provide care?</span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif;">The answer lies in legislation. The laws and regulations in place for
telemedicine are significantly outdated. Why is my medical license in one state
insufficient in another? Big changes are needed to reflect the advent of
technology’s integration into medicine. And when it comes down to it, it’s the
patients who suffer from these outdated practices the most.</span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif;">The shortage of psychiatric prescribers, as well as other types of
providers in the United States is a growing problem. Telemedicine is an
important way of addressing that shortage with the providers we already have.</span><br />
<a href="https://images-blogger-opensocial.googleusercontent.com/gadgets/proxy?url=http%3A%2F%2F4.bp.blogspot.com%2F-ozKMwielFQY%2FU4Y4C0-6mjI%2FAAAAAAAABAY%2FP9Me8RVUylE%2Fs1600%2FFSMB.png&amp;container=blogger&amp;gadget=a&amp;rewriteMime=image%2F*" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-ozKMwielFQY/U4Y4C0-6mjI/AAAAAAAABAY/P9Me8RVUylE/s1600/FSMB.png" /></a><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></div>
<div class="MsoNormal" style="background: white; margin: 0in 0in 0pt;">
<a href="http://4.bp.blogspot.com/-ozKMwielFQY/U4Y4C0-6mjI/AAAAAAAABAY/P9Me8RVUylE/s1600/FSMB.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><span style="font-family: Arial, Helvetica, sans-serif;"></span></a><span style="font-family: Arial, Helvetica, sans-serif;"><span style="background-color: white; background-position: initial initial; background-repeat: initial initial; color: black;">Thankfully, there is yet hope. The Federation of State Medical Boards
(FSMB) has recognized this unnecessary obstacle to patient care and the strain
inflicted on telemedicine as an industry.&nbsp; At its annual meeting at the end
of April, the FSBM will vote on adopting the <a href="http://www.fsmb.org/pdf/fsmb_news_rrelease_multistate_compacts.pdf" target="_blank">federation’s Interstate Medical Licensure Compact,</a> a licensing option that would allow qualified physicians to
expedite licensure in all states who participate in the Compact. Telemedicine
as a field of practice would be transformed dramatically with the adoption of
the Compact. Fingers crossed.</span></span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif;">I am enthusiastic about potential for growth of telepsychiatry and
telemedicine. But I believe providers must take an active role in pioneering
this new form of care, and pushing for its successful implementation for the
people who need it—our patients.</span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif;">Bottom line—we are in this for our patients, and it is our patients who
will benefit the most from telemedicine and a successful reevaluation of the
legislation that regulates it.</span></div>
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<o:p></o:p></div>
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</script>American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-91104745443165959522014-03-12T16:03:00.000-04:002015-01-23T15:37:15.775-05:00How Psychotherapy Changes the Brain<b style="mso-bidi-font-weight: normal;"><span style="font-family: Calibri;">By <a href="http://www.psychiatry.org/mental-health/healthy-minds-blog-contributors" target="_blank">Serina Deen, MDMPH</a><o:p></o:p></span></b><br />
<span style="font-family: Calibri;"></span><br />
<span style="font-family: Calibri;">When I first see patients for evaluation, they often tell me
that they’ve debated starting a “biological” treatment such as medication,
versus a “psychological” treatment such as psychotherapy. I’m happy to report
that as brain imaging technology advances, we’re finding that this distinction
may be obsolete.<span style="mso-spacerun: yes;">&nbsp; </span><o:p></o:p></span><br />
<br />
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: Calibri;">Psychotherapy is also “biological” in that it can lead to
real functional and structural changes in the brain.<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span>In fact, sometimes <a href="http://www.psychiatry.org/File%20Library/Mental%20IIlness/Lets%20Talk%20Facts/APA_Psycotherapy.pdf" target="_blank">psychotherapy </a>and
<a href="http://apahealthyminds.blogspot.com/2011/01/six-tips-for-talking-to-your-doctor.html" target="_blank">medication </a>produce surprisingly similar changes in the brain.<span style="mso-spacerun: yes;">&nbsp; </span>We still have a lot to learn about the topic,
but below are some examples of what researchers have been finding so far.<o:p></o:p></span></div>
<b style="mso-bidi-font-weight: normal;"><span style="font-family: Calibri;">Functional Changes in
the Brain:<o:p></o:p></span></b><br />
<a href="http://2.bp.blogspot.com/-wXUVAEghHAw/UyCzBKJ8heI/AAAAAAAAAyw/QAUwcvxVI9E/s1600/Deen+pic+1.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://2.bp.blogspot.com/-wXUVAEghHAw/UyCzBKJ8heI/AAAAAAAAAyw/QAUwcvxVI9E/s1600/Deen+pic+1.jpg" height="130" width="200" /></a><span style="font-family: Calibri;">In one study, researchers at UCLA found that people who
suffered from depression had abnormally high activity in an area of the brain
called the prefrontal cortex. <span style="mso-spacerun: yes;">&nbsp;</span>Those who
got better after they were treated with a type of therapy called interpersonal
therapy (IPT) showed a decrease in activity in the prefrontal cortex after
treatment.<span style="mso-spacerun: yes;">&nbsp; </span>In other words, IPT seemed to
“normalize” brain activity in this hyperactive region.</span><br />
<br />
<span style="font-family: Calibri;">Another study looked at people who have <a href="http://www.psychiatry.org/obsessive-compulsive-disorder" target="_blank">obsessive compulsive disorder</a> (OCD), who tend to have an overactive area of the brain called the
caudate nucleus.<span style="mso-spacerun: yes;">&nbsp; </span>Treatment with a type
of therapy called cognitive behavior therapy (CBT) was associated with a
decrease in the hyperactivity of the caudate nucleus, and the effect was most
evident in people who had a good response to CBT.<span style="mso-spacerun: yes;">&nbsp; </span>In other words, the better the therapy seemed
to work, the more the brain activity changed.</span><br />
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</div>
<div style="clear: both; text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: Calibri;">Changes in Brain
Volume:</span></b></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://3.bp.blogspot.com/-kbSy5ZVPf3U/UyCzcg7hu3I/AAAAAAAAAy4/vsMdIdFUkPQ/s1600/deen+pic+2.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://3.bp.blogspot.com/-kbSy5ZVPf3U/UyCzcg7hu3I/AAAAAAAAAy4/vsMdIdFUkPQ/s1600/deen+pic+2.jpg" height="137" width="200" /></a></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: Calibri;">People with chronic fatigue syndrome (CFS) suffer from debilitating
fatigue.<span style="mso-spacerun: yes;">&nbsp; </span>People with CFS tend to have a
decrease in a type of brain tissue called grey matter in the prefrontal cortex
of the brain.<span style="mso-spacerun: yes;">&nbsp; </span>Researchers in the
Netherlands gave people with CFS 16 sessions of CBT, and found significant
increases in gray matter volume in the prefrontal cortex. <span style="mso-spacerun: yes;">&nbsp;</span>This seems to suggest that the CFS patients
were able to “recover” some gray matter volume after CBT.</span></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: Calibri;">Similarities and
Differences to Medications</span></b></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: Calibri;"><a href="http://www.psychiatry.org/File%20Library/Mental%20IIlness/Lets%20Talk%20Facts/APA_Psycotherapy.pdf" target="_blank">Psychotherapy </a>sometimes seems to work in similar ways as
<a href="http://apahealthyminds.blogspot.com/2011/01/six-tips-for-talking-to-your-doctor.html" target="_blank">medications</a>, and other times appears to have different mechanisms of action.</span></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: Calibri;">In the study mentioned previously about people with
<a href="http://www.psychiatry.org/mental-health/depression" target="_blank">depression,</a> both IPT and the antidepressant paroxetine (Paxil) showed a
decrease in prefrontal cortex activity.<span style="mso-spacerun: yes;">&nbsp; </span>And
with OCD patients, both CBT and the antidepressant fluoxetine (Prozac) produced
similar decreases in activity in the caudate nucleus.<span style="mso-spacerun: yes;">&nbsp; </span></span></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: Calibri;"><span style="mso-spacerun: yes;"></span></span><span style="font-family: Calibri;">However in a different study, the antidepressant Venlafaxine
(Effexor) produced changes in different parts of the brain than IPT in
depressed patients.<span style="mso-spacerun: yes;">&nbsp; </span>This shows that there
is variability in how different treatments work in the brain.</span></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: Calibri;">How Psychotherapy
Produces Brain Change</span></b></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: Calibri;">We now know that the brain keeps changing, even after we
become adults.<span style="mso-spacerun: yes;">&nbsp; </span>Learning leads to the
production of new proteins, which in turn can change connectivity in our brains
in a process called neuroplasticity.<span style="mso-spacerun: yes;">&nbsp; </span><span style="mso-spacerun: yes;">&nbsp;</span>Indeed, researchers in Germany showed that
certain neurochemicals involved in neuroplasticity increased in depressed
patients who got better after a course of interpersonal therapy.<span style="mso-spacerun: yes;">&nbsp; </span></span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://3.bp.blogspot.com/-EJszkZjDO88/UyC0I0v2NHI/AAAAAAAAAzA/y3PlS6kDjM4/s1600/deen+pic+3.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://3.bp.blogspot.com/-EJszkZjDO88/UyC0I0v2NHI/AAAAAAAAAzA/y3PlS6kDjM4/s1600/deen+pic+3.jpg" height="193" width="200" /></a></div>
<br />
<div style="text-align: left;">
<span style="font-family: Calibri;"><span style="mso-spacerun: yes;"><b style="mso-bidi-font-weight: normal;">Picking a Treatment
that Works Best for You</b><br />
Even though we know that both <a href="http://apahealthyminds.blogspot.com/2011/01/six-tips-for-talking-to-your-doctor.html" target="_blank">medication</a> and <a href="http://www.psychiatry.org/File%20Library/Mental%20IIlness/Lets%20Talk%20Facts/APA_Psycotherapy.pdf" target="_blank">psychotherapy</a>
can change our brain, we still have a long way to go in learning exactly how
that happens and when to use what treatment. Given a specific mental illness,
sometimes medications work best, sometimes psychotherapies are the best option,
and sometimes it’s a combination of the two.<span style="mso-spacerun: yes;">&nbsp;
</span>In addition, there are different types of psychotherapies that work for
different illnesses, just as there are many different types of
medications.<span style="mso-spacerun: yes;">&nbsp; </span>If you’re considering
seeking help for mental illness, it would be helpful to talk with a trained
professional about what would work best for you.<span style="mso-spacerun: yes;">&nbsp; </span><o:p></o:p><br />
<span style="font-family: Times New Roman;">
</span><br />
</span></span><span style="font-family: Calibri;"><span style="mso-spacerun: yes;">Read&nbsp;tips on what to expect during your <a href="http://apahealthyminds.blogspot.com/2013/03/what-to-expect-for-your-first-visit_21.html" target="_blank">first visit with a psychiatrist</a>&nbsp;<span style="mso-spacerun: yes;">&nbsp; </span></span></span></div>
<div style="text-align: left;">
<span style="font-family: Calibri;"><span style="mso-spacerun: yes;">
</span></span></div>
<div style="text-align: left;">
<span style="font-family: Calibri;"><span style="mso-spacerun: yes;">"Let's Talk Facts" brochure on <a href="http://www.psychiatry.org/File%20Library/Mental%20IIlness/Lets%20Talk%20Facts/APA_Psycotherapy.pdf" target="_blank">Psychotherapy</a></span></span></div>
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<span style="font-family: Calibri;"><span style="mso-spacerun: yes;"><a href="http://www.nimh.nih.gov/about/director/2014/brain-awareness.shtml?utm_source=govdelivery&amp;utm_medium=email&amp;utm_campaign=govdelivery" target="_blank">Brain Awareness blog</a> post from NIMH Director Tom Insel, MD </span></span></div>
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<span style="font-family: Calibri;"><span style="mso-spacerun: yes;">APA Releases <a href="http://apahealthyminds.blogspot.com/2013/11/apa-releases-list-of-five-uses-of.html"><span style="color: blue;">List
of Five Uses of Psychiatric Medication</span></a> to Question<o:p></o:p></span></span></div>
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<span style="font-family: Calibri;"><span style="mso-spacerun: yes;">Six tips for talking to your doctor about <a href="http://apahealthyminds.blogspot.com/2011/01/six-tips-for-talking-to-your-doctor.html"><span style="color: blue;">medication
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<span style="font-family: Calibri;"><span style="mso-spacerun: yes;">For more information about <a href="http://www.apa.org/helpcenter/understanding-psychotherapy.aspx"><span style="color: blue;">psychotherapy
</span></a><o:p></o:p></span></span></div>
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<a class="twitter-share-button" data-count="horizontal" data-related="APAPsychiatric" data-via="APAHealthyMinds" href="http://twitter.com/share" style="text-align: center;">Tweet</a></div>
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American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-91827392321375232072014-02-05T11:24:00.000-05:002015-01-23T15:38:17.530-05:00Effective Addiction Treatments are Available <span style="color: blue; font-family: Calibri; font-size: large;"></span><br />
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<span style="font-family: Calibri;"><span style="font-size: large;">B</span><span style="font-size: large;">y John Renner, MD and Frances Levin, MD<o:p></o:p></span></span></div>
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<span style="font-family: Calibri; font-size: large;">We are all saddened by the death of <span lang="EN">Philip Seymour Hoffman </span>and the many other
individuals who have died because of overdoses of heroin or pain
medications.&nbsp; For all of those individuals who struggle with opioid use
problems, it is important to realize that help is available and that effective
treatment can restore them to productive lives.&nbsp; Some 4.7 million people
in the U.S. have used heroin at least once in their lives.&nbsp; It is estimated that nearly a quarter of
people that use heroin become dependent on it.<br />
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Whether it be through mutual support programs such as NA, long-term residential
treatment, or addiction pharmacotherapy with buprenorphine, methadone or ER
naltrexone, no individual need fear that their condition cannot be
treated.&nbsp; Friends and family members also need to be educated in the use
of intra-nasal naloxone for the reversal of opioid overdoses.&nbsp;&nbsp; <br />
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APA has long fostered&nbsp;the development of addiction focused training </span><span style="font-size: large;"><a href="http://www.psychiatry.org/practice/professional-interests/addiction-psychiatry"><span style="color: blue; font-family: Calibri;">programs
for psychiatrists</span></a></span><span style="font-family: Calibri; font-size: large;">.&nbsp; Many psychiatrists have been specifically trained
to provide office-based addiction pharmacotherapy and to manage the
co-occurring psychiatric disorders that often complicate recovery from
substance use disorders.&nbsp;&nbsp;<o:p></o:p></span></div>
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<span style="font-size: large;"><b><span style="font-family: Calibri;">More information:<o:p></o:p></span></b></span></div>
<span style="font-family: Symbol; font-size: large;">·<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: &quot;Times New Roman&quot;; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span><span style="font-family: Calibri; font-size: large;">Information on </span><span style="font-size: large;"><a href="http://www.psychiatry.org/addiction"><span style="color: blue; font-family: Calibri;">addiction</span></a><span style="font-family: Calibri;"> </span></span><br />
<span style="font-size: large;"><span style="font-family: Symbol; font-size: large;">·<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: &quot;Times New Roman&quot;; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span><span style="font-size: large;"><a href="http://store.samhsa.gov/product/Opioid-Overdose-Prevention-Toolkit/SMA13-4742" target="_blank"><span style="color: blue; font-family: Calibri;">Opioid Overdose Prevention Toolkit</span></a></span><span style="font-family: Calibri; font-size: large;"> (SAMHSA)<o:p></o:p></span><br />
<o:p></o:p></span><span style="font-family: Symbol; font-size: large;">·<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: &quot;Times New Roman&quot;; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span><span style="font-size: large;"><a href="http://findtreatment.samhsa.gov/TreatmentLocator/faces/quickSearch.jspx"><span style="color: blue; font-family: Calibri;">Substance
use treatment locator</span></a></span><span style="font-family: Calibri; font-size: large;"> (SAMHSA)<o:p></o:p></span><br />
<span style="font-family: Symbol; font-size: large;">·<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: &quot;Times New Roman&quot;; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span><span style="font-size: large;"><a href="http://buprenorphine.samhsa.gov/bwns_locator/"><span style="color: blue; font-family: Calibri;">Buprenorphine Physician
and Treatment locator</span></a></span><span style="font-family: Calibri; font-size: large;"> (SAMHSA)<o:p></o:p></span><br />
<span style="font-family: Symbol; font-size: large;">·<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-family: &quot;Times New Roman&quot;; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span><span style="font-family: Calibri; font-size: large;">For psychiatrists: &nbsp;</span><span style="font-size: large;"><a href="http://pcssmat.org/"><span style="color: blue; font-family: Calibri;">Providers
Clinical Support System for Medication Assisted Treatment</span></a><o:p></o:p></span><br />
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<b><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;;"><span style="font-size: large;">Blog
contributors:</span><o:p></o:p></span></b></div>
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<a href="http://2.bp.blogspot.com/-Ofo4edMWxtY/UvFcrabrxHI/AAAAAAAAAyc/eubxcdyVte4/s1600/renner2.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-Ofo4edMWxtY/UvFcrabrxHI/AAAAAAAAAyc/eubxcdyVte4/s1600/renner2.jpg" height="170" width="135" /></a><b><span style="font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;;">John
Renner, MD<o:p></o:p></span></b></div>
<span style="font-family: Calibri;"><span style="font-size: x-small;">Member, APA Council on Addicition Psychiatry (Past Chair)<br />Director of Addiction Fellowship Program,<o:p></o:p></span></span><br />
<span style="font-size: x-small;"><span style="font-family: Calibri;">Professor of Psychiatry,<span style="mso-spacerun: yes;">&nbsp; </span>Boston University School of Medicine<o:p></o:p></span></span><br />
<span style="font-size: x-small;">
<span style="font-family: Calibri;">Associate Chief of Psychiatry, VA Boston Healthcare System<o:p></o:p></span></span><br />
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<a href="http://2.bp.blogspot.com/-HVSelmRz3os/UvFchsGxd-I/AAAAAAAAAyU/Vp6bWczaW7Y/s1600/levin.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-HVSelmRz3os/UvFchsGxd-I/AAAAAAAAAyU/Vp6bWczaW7Y/s1600/levin.jpg" height="145" width="135" /></a><span class="factitle1"><span style="color: black; font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; letter-spacing: 0.2pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;"><b></b></span></span></div>
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<span class="factitle1"><span style="color: black; font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; letter-spacing: 0.2pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;"><b><br /><br />Frances Levin, MD</b></span></span></div>
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<span style="font-size: x-small;"><span style="color: black; letter-spacing: 0.2pt;"><span style="font-family: Calibri;">Chair, APA Council on Addiction Psychiatry<br />Kennedy-Leavy Professor of Psychiatry, Columbia University Medical Center<br />
Director, Addiction Psychiatry Fellowship, <br />
New York Presbyterian Hospital<br />
New York State Psychiatric Institute</span><span style="color: black;"></span></span></span></div>
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<span style="color: black; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; mso-themecolor: text1;"><o:p></o:p></span><br /></div>
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</script>American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-80094131209804441492014-01-10T16:51:00.000-05:002015-01-23T09:26:37.547-05:00Need a New Year’s Resolution? Try Exercise!<span style="font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family: &quot;Times New Roman&quot;;">By Ahmed Raza Khan, MD, MPH <o:p></o:p></span><br />
<span style="font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family: &quot;Times New Roman&quot;;">Follow<a href="https://twitter.com/AhmedRazaKhanMD"><span style="color: blue;">@AhmedRazaKhanMD</span></a><o:p></o:p></span><br />
<span style="color: #222222; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 11pt; mso-bidi-font-family: &quot;Times New Roman&quot;;">Child and Adolescent Psychiatry Physician at Stanford University
School of Medicine <o:p></o:p></span><br />
<br />
<span style="font-family: inherit;">Most people know that exercise is beneficial for cardiac health and is prescribed by physicians for the prevention and alleviation of various medical complications. But what if I told you exercise can also significantly benefit your mental health in more ways than one? Let’s take a look at some of the ways exercise can improve mental health and how to incorporate this into your new year’s resolution list!</span><br />
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<a href="http://1.bp.blogspot.com/-gvp8WiC1ARk/Us7QIYzoAnI/AAAAAAAAAx4/4P52Uqn-z9g/s1600/Khan+chart+photo.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/-gvp8WiC1ARk/Us7QIYzoAnI/AAAAAAAAAx4/4P52Uqn-z9g/s1600/Khan+chart+photo.png" height="299" width="320" /></a></div>
<span style="font-family: inherit;">Exercise and Depression Prevention:<span style="color: #222222; font-size: 10pt; mso-bidi-font-family: &quot;Times New Roman&quot;;">More than 350 million people in the world suffer from <a href="http://www.psychiatry.org/depression"><span style="color: blue;">depression</span></a> and it is the leading
cause of disability worldwide.<span style="mso-spacerun: yes;">&nbsp; </span>Exercise
has often been considered as a supplemental tool in treating depression, but
recent evidence points to exercise playing a role in the prevention of future
depressive episodes. These recent findings show that even low levels of
physical activity (e.g., walking less than 150 minutes a week) can prevent
future depression. There has been significant research in the last few years
that links cardiovascular health’s role in the origin of depression. This would
certainly be a plausible explanation for why exercise may prevent depression. <o:p></o:p></span></span><br />
<span style="font-family: inherit;"></span><br />
<span style="font-family: inherit;">Alzheimer’s Disease Prevention:<span style="color: #222222; font-size: 10pt; mso-bidi-font-family: &quot;Times New Roman&quot;; mso-bidi-font-weight: bold;"><a href="http://www.psychiatry.org/mental-health/key-topics/alzheimers-disease"><span style="color: blue;">Alzheimer’s
disease</span></a> is a chronic, degenerative disease of the brain that affects over
25 million people in the world. This illness leads to a progressive mental
decline, steering its victims to dependence on caregivers and, eventually,
death. Amyloid plaques are abnormal clusters of protein fragments that are
found in the brains of patients with Alzheimer’s disease and are thought to
play a major role in its progression. Recent studies have found that people who
exercised at or above the levels recommended by the American Heart Association
had significantly lower numbers of amyloid plaques than those who exercised
less. This was the case for even those who carried </span><span style="font-size: 10pt;">the APOE-e4 gene
variant, which is an established risk factor for Alzheimer’s disease. When
people with the APOE-e4 gene variant were compared, those with higher levels of
exercise had lower levels of amyloid plaques.</span><span style="color: #222222; font-size: 10pt; mso-bidi-font-family: &quot;Times New Roman&quot;;"><o:p></o:p></span></span><br />
<span style="font-family: inherit;"></span><br />
<span style="font-family: inherit;">Improving Cognitive Functioning:<span style="color: #222222; font-size: 10pt; mso-bidi-font-family: &quot;Times New Roman&quot;; mso-fareast-font-family: &quot;Times New Roman&quot;;">Exercise has been shown
to increase cognitive functioning in rats. As rats get older, their memory
tends to diminish and this appears to be due to a drop of nerve synapses in the
hippocampus, the memory center of the brain. But after 12 weeks of voluntary
running, both memory and hippocampus nerve synapses were restored in these
rats. <o:p></o:p></span></span><br />
<span style="font-family: inherit;"></span><br />
<span style="font-family: inherit;">Consistency in Exercise:<span style="color: #222222; font-size: 10pt; mso-bidi-font-family: &quot;Times New Roman&quot;; mso-fareast-font-family: &quot;Times New Roman&quot;;">Recent neuroscientific
studies have shown that the cognitive benefit of exercise may have a window of
time. In fact, rats that improved their cognitive functioning by exercise, had
this improvement dissipate in 3-6 weeks of inactivity. This is similar to what
is seen with muscle mass or heart rate when exercise is withdrawn. This
evidence intimates that exercise is beneficial for the brain and should be
performed consistently.<o:p></o:p></span></span><br />
<span style="font-family: inherit;"></span><br />
<span style="color: #222222; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 10pt; mso-bidi-font-family: &quot;Times New Roman&quot;; mso-fareast-font-family: &quot;Times New Roman&quot;;"><span style="font-family: inherit;">The </span><a href="http://www.heart.org/HEARTORG/"><span style="color: blue; font-family: inherit;">American Heart Association</span></a><span style="font-family: inherit;"> is a great
resource for planning the amount and type of exercise one needs. They recommend
at least 30 minutes of moderate-intensity aerobic activity at least 5 days a
week for a total of 150 minutes or at least 25 minutes of vigorous aerobic
activity 3 days a week for a total of 75 minutes. An easy target to remember:
30 minutes a day, 5 days a week.</span> <o:p></o:p></span><br />
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<a href="http://4.bp.blogspot.com/-fQIqCkVejlA/Us7QdTalBvI/AAAAAAAAAyA/Gc-erKGY9zM/s1600/Dr.+Khan+high+inten+photo.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-fQIqCkVejlA/Us7QdTalBvI/AAAAAAAAAyA/Gc-erKGY9zM/s1600/Dr.+Khan+high+inten+photo.jpg" height="320" width="270" /></a></div>
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</script>American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-71493008480687556692013-11-19T11:11:00.000-05:002014-05-14T15:23:19.218-04:00APA Releases List of Five Uses of Psychiatric Medication to Question<div class="MsoNormal" style="margin-bottom: 0in;">
<b><span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">Continuing
the Conversation about <i>Choosing Wisely</i>:
The American Psychiatric Association Releases List of Five Uses of Psychiatric Medication to Question<o:p></o:p></span></b></div>
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<span style="font-family: Arial, sans-serif;">Joel Yager, MD,&nbsp;</span></div>
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<span style="font-family: Arial, sans-serif;">Professor, University of Colorado School of Medicine</span></div>
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<span style="font-family: Arial, sans-serif;">Chair of the APA Council on Quality Care</span></div>
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<span style="font-family: Arial, sans-serif;"><br /></span></div>
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<span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">Recently the APA released a list of
“Five Things Physicians and Patients Should Question” in Psychiatry as part of
the <i>Choosing Wisely</i><sup>®</sup>
campaign, led by the ABIM Foundation. The list
identifies five specific evidence-based recommendations that can help
physicians and patients make wise choices about their care.<o:p></o:p></span></div>
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<span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">The APA list contains the following
five recommendations: <o:p></o:p></span></div>
<ul style="margin-top: 0in;" type="disc">
<li class="MsoNormal" style="margin-bottom: 0in; mso-list: l0 level1 lfo1;"><span style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">Don’t
prescribe antipsychotic medications to patients for any indication without
appropriate initial evaluation and appropriate ongoing monitoring.</span><span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;"><o:p></o:p></span></li>
<li class="MsoNormal" style="margin-bottom: 0in; mso-list: l0 level1 lfo1;"><span style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">Don’t
routinely prescribe two or more antipsychotic medications concurrently.
&nbsp;</span><span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;"><o:p></o:p></span></li>
<li class="MsoNormal" style="margin-bottom: 0in; mso-list: l0 level1 lfo1;"><span style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">Don’t
prescribe antipsychotic medications as a first-line intervention to treat
behavioral and psychological symptoms of dementia. &nbsp; &nbsp;</span><span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;"><o:p></o:p></span></li>
<li class="MsoNormal" style="margin-bottom: 0in; mso-list: l0 level1 lfo1;"><span style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">Don’t
routinely prescribe antipsychotic medications as a first-line intervention
for insomnia in adults. &nbsp;&nbsp;</span><span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;"><o:p></o:p></span></li>
<li class="MsoNormal" style="margin-bottom: 0in; mso-list: l0 level1 lfo1;"><span style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">Don’t
routinely prescribe antipsychotic medications as a first-line intervention
for children and adolescents for any diagnosis other than psychotic
disorders</span><span style="color: #333333; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 9pt; line-height: 115%;">.</span><span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;"><o:p></o:p></span></li>
</ul>
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<b><span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">Why
was this list created?</span></b></div>
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<a href="http://4.bp.blogspot.com/-EcLALCZFx9c/UoyvRJ-G5NI/AAAAAAAAAxU/rkRaXfgxNjQ/s1600/prescription+patient.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img 150="" border="0" height="138" src="http://4.bp.blogspot.com/-EcLALCZFx9c/UoyvRJ-G5NI/AAAAAAAAAxU/rkRaXfgxNjQ/s200/prescription+patient.jpg" unselectable="on" width="200" /></a><span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">This list was created to help
clinicians and patients reduce the number of times that certain medications are
routinely prescribed in situations where other initial treatments might be
preferable, and where risks of these medications’ harmful side effects could be
decreased or avoided.&nbsp; <o:p></o:p></span></div>
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<b><span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">Does
this list apply to the care of children or adolescents?<o:p></o:p></span></b></div>
<div class="Default">
<span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">For
any indication and for any patient, the potential harms of treatment must be
weighed against the potential benefits. For the <i>Choosing Wisely</i> campaign, the APA recognizes that for some young
patients in some circumstances an antipsychotic medication may turn out to be an
appropriate choice of treatment if the clinical benefits are judged to outweigh
potential harms after the patient receives appropriate initial evaluation and will
receive ongoing monitoring. However, the APA advises physicians and patients to
question the <i>routine</i> use of
antipsychotic medications in children and adolescents for clinical
circumstances where these medications are not endorsed by available clinical
practice guidelines or lack explicit FDA approval indications for their use.<o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">Why
the <i>Choosing Wisely</i> Campaign?<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: 0in;">
<span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">The facts driving the <i>Choosing Wisely</i> effort are well known: Current
health care practices in America spend too much money on unnecessary tests and
procedures that do not benefit patients and that may even cause unintended harm.
According to a </span><a href="http://www.nap.edu/catalog.php?record_id=13444"><span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">report</span></a><span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;"> from the Institute of Medicine, up to
30 percent of health care delivered in the United States is wasteful. Providers
and economists agree that these costly unnecessary practices threaten America’s
ability to provide the highest quality of care possible to all patients.<span id="ctl12_GenericContentBlock_ctl00"></span><o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-bottom: 0in;">
<a href="http://choosingwisely.org/" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;" target="_blank"><img alt="Choosing Wisely" src="http://choosingwisely.org/wp-content/uploads/2011/11/web-banner2.png" style="border: 0px solid currentColor; float: right; height: 138px; width: 250px;" title="" /></a><span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">Through the <i>Choosing Wisely</i> campaign and by publishing this list, the APA hopes
to spark conversations between its members and patients about whether certain
tests and treatments are really necessary or the best ones to choose. The APA joined
the campaign<i> </i>because it recognizes
that physicians have professional, moral and ethical responsibilities to take
the lead in addressing these challenges. <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-bottom: 0in;">
<span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">While the APA has taken a bold step in
identifying and developing the list, our work doesn’t stop here. Over the
coming months and years, the APA will be working with the ABIM Foundation,
Consumer Reports, and a variety of other <i>Choosing
Wisely </i>campaign stakeholders to raise awareness of these lists and to make
them available to patients and the public at large.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-bottom: 0in;">
<span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">Learn more about <i>Choosing Wisely</i> and read all the lists released to date at </span><a href="http://www.choosingwisely.org/"><span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">www.choosingwisely.org</span></a><span style="font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;">. <o:p></o:p></span></div>
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<br /></div>
<br />
<div class="Default">
<a href="http://www.choosingwisely.org/" target="_blank">www.choosingwisely.org</a></div>
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</script>American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-40204528848583881662013-10-28T10:58:00.000-04:002013-10-29T16:57:56.993-04:00Cyberbullying: an Update on Intimidation in the Digital Playground<div class="MsoNormal">
<a href="http://2.bp.blogspot.com/-faCdhIwDwkM/UiZZLmuI5MI/AAAAAAAAAsg/30WFk6RXCEw/s1600/Dr+V+headshot+2.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="100" src="http://2.bp.blogspot.com/-faCdhIwDwkM/UiZZLmuI5MI/AAAAAAAAAsg/30WFk6RXCEw/s200/Dr+V+headshot+2.jpg" width="88" /></a></div>
<span style="color: #333333; font-family: Arial, Helvetica, sans-serif;">By </span><a href="http://www.psychiatry.org/mental-health/healthy-minds-blog-contributors" style="font-family: Arial, Helvetica, sans-serif;" target="_blank">Arshya Vahabzadeh, M.D.</a><span style="color: #333333; font-family: Arial, Helvetica, sans-serif;"> </span><br />
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #333333;">Follow <a href="https://twitter.com/VahabzadehMD" target="_blank">@VahabzadehMD</a></span><b><span style="font-size: 10.0pt; line-height: 107%;"><br /></span></b></span></div>
<b><span style="font-size: 10.0pt; line-height: 107%;"><span style="font-family: Arial, Helvetica, sans-serif;">
American Psychiatric Association Leadership Fellow </span></span></b><br />
<br />
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-size: 10.0pt; line-height: 107%;"><span style="font-family: Arial, Helvetica, sans-serif;">Resident Physician in Child and Adolescent Psychiatry at
MGH/McLean/Harvard Medical School<o:p></o:p></span></span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal">
<b><span style="font-size: 14.0pt; line-height: 107%;"><span style="font-family: Arial, Helvetica, sans-serif;">What is cyberbullying?<o:p></o:p></span></span></b></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 107%;"><span style="font-family: Arial, Helvetica, sans-serif;">Cyberbullying
is <a href="http://www.psychiatry.org/mental-health/bullying">bullying</a>,
intimidation, and harassment that happens with the aid of electronic technology.
<a href="http://www.psychiatry.org/mental-health/cyberbullying" target="_blank">Cyberbullying</a> can happen through text messaging, social media, and emails. The
boundaries of cyberbullying continue to expand as new communication
technologies emerge. <o:p></o:p></span></span></div>
<div class="MsoNormal">
<a href="http://4.bp.blogspot.com/-Zs7jb4K8eBo/UmaZXJJWaAI/AAAAAAAAAvQ/P_cpbXrWZzQ/s1600/cyberbullying2.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="132" src="http://4.bp.blogspot.com/-Zs7jb4K8eBo/UmaZXJJWaAI/AAAAAAAAAvQ/P_cpbXrWZzQ/s200/cyberbullying2.jpg" width="200" /></a><span style="font-size: 12.0pt; line-height: 107%;"><span style="font-family: Arial, Helvetica, sans-serif;">Cyberbullying is emerging as a major
problem, with new research from the Bureau for Justice Statistics revealing
that 9% of <a href="http://www.psychiatry.org/teens" target="_blank">teenagers</a> aged 12-18 have reported being cyberbullied in a given
year. <o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 107%;"><span style="font-family: Arial, Helvetica, sans-serif;">Female
students are more likely to experience cyberbullying. The most common forms of
cyberbullying include harassment by text or instant messaging, or the posting
of hurtful information on the internet. Despite the high levels of
cyberbullying, an adult is notified in only a quarter of cases.</span></span></div>
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<b><span style="font-size: 14.0pt; line-height: 107%;"><br />
</span></b></div>
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<b><span style="font-size: 14.0pt; line-height: 107%;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">How is cyberbullying different than traditional bullying?</span></span></b></div>
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<span style="font-size: 12.0pt; line-height: 107%;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">Cyberbullying
can continue 24 hours a day and is not dependent on location. While traditional
bullying often requires the physical presence of a bully, a child can be
cyberbullied at anytime and anywhere they are in contact with communication
technology, including their own cell phone. There may be no “safe” zone and
this may intensify the level of distress that the cyberbullying can produce.<o:p></o:p></span></span></div>
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<span style="font-size: 12.0pt; line-height: 107%;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><br /></span></span></div>
<div class="MsoNormal">
<a href="http://4.bp.blogspot.com/-X0OcYkfdjpg/UmaZXECvwXI/AAAAAAAAAvM/QPHRRP8Q51E/s1600/cyberbullying.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="132" src="http://4.bp.blogspot.com/-X0OcYkfdjpg/UmaZXECvwXI/AAAAAAAAAvM/QPHRRP8Q51E/s200/cyberbullying.jpg" width="200" /></a><span style="font-size: 12.0pt; line-height: 107%;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">Material
such as digital pictures, text messages, or social media posts designed to hurt
an individual can be rapidly distributed to a large group of people. Often it
is difficult to find out the source of the information, giving a degree of
anonymity to the cyberbully. <o:p></o:p></span></span></div>
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<span style="font-size: 12.0pt; line-height: 107%;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">Harassing
and intimidating material, once distributed through digital means are also much
more difficult to remove. Often videos or pictures may stay indefinitely
available through digital means.<o:p></o:p></span></span></div>
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<b><span style="font-size: 14.0pt; line-height: 107%;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><br /></span></span></b></div>
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<b><span style="font-size: 14.0pt; line-height: 107%;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">What are the effects of cyberbullying?</span></span></b></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 107%;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">P</span></span><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif; font-size: 12pt; line-height: 107%;">eople who are
cyberbullied are thought to be at risk of the same consequences of traditional
bullying. These effects include increased <a href="http://www.psychiatry.org/depression" target="_blank">depression</a>, decreased self-worth,
hopelessness, and loneliness. There is some evidence to suggest that being
cyberbullied may result in <a href="http://www.psychiatry.org/suicide" target="_blank">suicidal</a> feelings in 20% of teenagers, a higher rate
than in traditional bullying.</span></div>
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<b><span style="font-size: 14.0pt; line-height: 107%;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><br /></span></span></b></div>
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<b><span style="font-size: 14.0pt; line-height: 107%;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">What can we do about cyberbullying?</span></span></b></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 107%;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><b><i>Promote Good
Digital Habits</i></b><o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
</div>
<ul>
<li><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif; font-size: 12pt; line-height: 107%; text-indent: -0.25in;">Keep
your <a href="http://www.psychiatry.org/children" target="_blank">children</a> informed about the risks of the technology they are using.</span></li>
<li><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif; font-size: 12pt; line-height: 107%; text-indent: -0.25in;">Engage
your children in a discussion on how to best deal with cyberbullying by
formulating a plan for dealing with text messages or other digital content that
is upsetting to them. Children should be made to feel as comfortable as
possible in discussing their experiences with trusted adults.</span></li>
<li><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif; font-size: 12pt; line-height: 107%; text-indent: -0.25in;">Review
and teach them about privacy settings for digital media. Talk to them about
limiting the amount of private information they share about themselves.</span></li>
<li><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif; font-size: 12pt; line-height: 107%; text-indent: -0.25in;">Tell
children to keep their passwords safe and not to share them with friends or
people they don’t know.</span></li>
</ul>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 107%;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><b><i>Take Action</i></b><o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l1 level1 lfo2; text-indent: -.25in;">
</div>
<ul>
<li><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif; font-size: 12pt; line-height: 107%; text-indent: -0.25in;">Approach
a child if you notice signs of changing behavior, especially if it is happening
when they are using the computer, their cell phone, or any other communication
device.</span></li>
<li><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif; font-size: 12pt; line-height: 107%; text-indent: -0.25in;">Consider
discussing the situation with the suspected bullies’ parents, the child’s
school, and other organizations they may be involved in.</span></li>
<li><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif; font-size: 12pt; line-height: 107%; text-indent: -0.25in;">Identify
and archive the cyberbullying material, it may be useful when contacting the Internet service provider, cell phone company, or in severe circumstances, the
police.</span></li>
<li><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif; font-size: 12pt; line-height: 107%; text-indent: -0.25in;">Consider
closing down targeted social media accounts or changing cell phone numbers.</span></li>
<li><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif; font-size: 12pt; line-height: 107%; text-indent: -0.25in;">Some
cyberbullies thrive on obtaining a reaction, avoiding replying to messages or
engaging with the cyberbully may also be useful in some situations.</span></li>
</ul>
<span style="font-family: Arial, Helvetica, sans-serif;">Public Service Announcement:
</span><br />
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<param value="#ffffff" name="bgcolor"></object><b><span style="font-size: 14.0pt; line-height: 107%;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">Where can I get more information?</span></span></b><br />
<div class="MsoNormal">
<span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">More on cyberbullying from <a href="http://www.stopbullying.gov/cyberbullying/">stopbullying.gov</a> and <a href="http://www.girlshealth.gov/bullying/whatis/cyberbully.html">girlshealth.gov
</a>&nbsp;and <a href="http://www.onguardonline.gov/articles/0028-cyberbullying">onguardonline.gov</a><o:p></o:p></span></div>
<span style="font-size: 11pt; line-height: 107%;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><br /></span></span><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><span style="font-size: 11pt; line-height: 107%;">More on
</span><a href="http://www.psychiatry.org/mental-health/bullying" style="font-size: 11pt; line-height: 107%;">bullying</a></span><br />
<span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><br /></span>
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</script>American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-72221887810799184822013-10-11T19:20:00.001-04:002014-01-08T12:47:37.433-05:00What You May Not Know about ADHD <div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: inherit;">By&nbsp;<span style="line-height: 115%;">Ahmed Khan, MD&nbsp;</span></span><br />
<a href="https://twitter.com/AhmedRazaKhanMD" target="_blank">@AhmedRazaKhanMD</a> <br />
<br />
<a href="http://2.bp.blogspot.com/-o_vp8to4OEk/UliGfXfU2LI/AAAAAAAAAuE/ldm5WIGqEV0/s1600/Foundation+stock+young+adults.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://2.bp.blogspot.com/-o_vp8to4OEk/UliGfXfU2LI/AAAAAAAAAuE/ldm5WIGqEV0/s320/Foundation+stock+young+adults.jpg" height="212" width="320" /></a><a href="http://www.psychiatry.org/adhd" style="font-family: inherit;">Attention-Deficit/Hyperactivity Disorder (ADHD)</a><span style="font-family: inherit;"> is an illness that affects many people living in this country. It's reported that 7-10% of Americans have ADHD - a disorder that alters one’s attention and concentration in a negative manner.&nbsp;</span><br />
<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;">Oftentimes, </span>parents<span style="font-family: inherit;"> and </span><a href="http://www.psychiatry.org/mental-health/people/children" style="font-family: inherit;">children</a><span style="font-family: inherit;"> conceptualize this lack of attention and concentration leading </span><i style="font-family: inherit;">solely</i><span style="font-family: inherit;"> to problems at work and school. Unfortunately, ADHD has a number of adverse health outcomes that you may not be aware of. Hopefully my post will help you understand the various&nbsp;</span><b style="font-family: inherit;">adverse health outcomes associated with ADHD</b><span style="font-family: inherit;">.</span></div>
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<i style="font-family: inherit;"><b><br /></b></i>
<i style="font-family: inherit;"><b><u>Substance Use and Smoking</u>:</b></i><span style="font-family: inherit;">&nbsp;Several studies show a significantly increased rate of <a href="http://www.psychiatry.org/addiction" target="_blank">substance abuse</a> disorders and smoking in patients with ADHD. This could be due to the increased impulsivity apparent in many people with ADHD.</span><br />
<br />
<i style="font-family: inherit;"><b><u>Sleep Problems</u>: </b></i><span style="font-family: inherit;">It's<i> pretty clear</i> that ADHD leads to dysregulation of <a href="http://apahealthyminds.blogspot.com/2012/11/sleep-hygiene-5-practical-tips-for-more.html" target="_blank">sleep</a>. This is often displayed by resisting sleep at <a href="http://apahealthyminds.blogspot.com/2011/09/significance-of-sleeping-brain.html" target="_blank">bedtime</a>, difficulty falling asleep once in bed, and problems awaking in the morning.</span><br />
<br />
<i style="font-family: inherit;"><b><u>Car Accidents</u>:</b></i><span style="font-family: inherit;">&nbsp;Did you know people with ADHD have a higher risk of traffic violations and car accidents? Some studies found this to be due to increased risk-taking behavior and poor frustration tolerance.</span><br />
<br />
<i style="font-family: inherit;"><b><u>Physical Injuries</u>:</b>&nbsp;</i><span style="font-family: inherit;">Studies have also revealed</span><span style="font-family: inherit;">&nbsp;</span><span style="font-family: inherit;">children with ADHD can have almost<i> twice</i> the injury rate as those without it (20.4% vs. 11.5%). A study looking at an insurance data base of over 100,000 people, from children to adults aged 64, found that those with ADHD had 1.55 times greater chance of injury versus those without ADHD.</span><br />
<br />
<i style="font-family: inherit;"><b><u>Risky Sexual Activity</u>:</b> </i><span style="font-family: inherit;">Studies suggest that the impulsivity, poor self-esteem, and risk-taking behaviors that are prevalent in people with ADHD can lead some to engage in risky sexual behavior and increase their risk of receiving and transmitting sexually-transmitted diseases.</span><br />
<br />
<i style="font-family: inherit;"><b><u>Obesity</u>:</b> </i><span style="font-family: inherit;">There is no direct correlation between ADHD and obesity yet, but some studies show that children with ADHD are more likely to be obese than those without it. This could be due to various reasons, but researchers are looking at genetic similarities between the two conditions which could provide more insight in near future.&nbsp;</span></div>
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<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;">So, did you learn something new about the often misunderstood ADHD? I hope my post provided you with a better idea of the toll that ADHD can take on one's life. With a thorough diagnosis and proper treatment by a trained <a href="http://apahealthyminds.blogspot.com/2013/03/what-to-expect-for-your-first-visit_21.html" target="_blank">psychiatrist</a>, a person with ADHD can greatly limit these adverse events and, many times, avoid such negative health issues all together.&nbsp;<o:p></o:p></span></div>
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<span style="font-family: inherit;"><br /></span></div>
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<br /></div>
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</script>American Psychiatric Association noreply@blogger.com1tag:blogger.com,1999:blog-4119237672383930848.post-22679717347672610682013-10-07T17:07:00.000-04:002013-10-07T17:24:04.864-04:00How to Help Loved One w/ Postpartum Depression?<div class="MsoNormal">
<span style="font-family: inherit;">By Nada Stotland, MD, MPH<o:p></o:p></span></div>
<a href="http://4.bp.blogspot.com/-oUhjj4jzJGk/UlMmSo7nWbI/AAAAAAAAAt0/_1pDtpf2910/s1600/HMHL+Headshots+053.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="http://4.bp.blogspot.com/-oUhjj4jzJGk/UlMmSo7nWbI/AAAAAAAAAt0/_1pDtpf2910/s200/HMHL+Headshots+053.jpg" width="132" /></a><span style="font-family: inherit;"><a href="http://www.psychiatry.org/postpartumdepression" target="_blank">Postpartum depression</a> simply means <a href="http://www.psychiatry.org/depression" target="_blank">depression</a> occurring after childbirth---any time from days after to up to a year after the birth of a baby.&nbsp;</span><br />
<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;">When we diagnosis depression---at any time in life---we don't mean the kind of "down" mood everybody experiences from time to time. We mean a <i><b>real</b> disease</i> that causes symptoms including interference with <a href="http://apahealthyminds.blogspot.com/2012/11/sleep-hygiene-5-practical-tips-for-more.html" target="_blank">sleep</a> and <a href="http://apahealthyminds.blogspot.com/2013/07/what-you-should-know-about-binge-eating.html" target="_blank">appetite</a>; thoughts of death; guilt; lack of interest in the activities of life; inability to feel pleasure---every day <i>for weeks</i>. It's a very painful, but fortunately very <b>treatable</b>, disease.&nbsp;</span><br />
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<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;">Depression is particularly painful for a mother with a new baby. People are often telling her that this should be the happiest time of her life, that she should appreciate her good fortune in being able to conceive and bear a child when many others have so much trouble.&nbsp; </span><br />
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<span style="font-family: inherit;">Other people---and even the new mother herself--may also confuse the symptoms of depression with the inevitable interruptions of <a href="http://apahealthyminds.blogspot.com/2011/03/how-much-sleep-do-kids-need.html" target="_blank">sleep</a> and meals by the demands of a newborn and the common concerns about being a good mother.&nbsp;</span><br />
<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;">It's important to distinguish postpartum depression from postpartum </span><a href="http://apahealthyminds.blogspot.com/search/label/psychosis" style="font-family: inherit;" target="_blank">psychosis</a><span style="font-family: inherit;">. Postpartum psychosis begins within days after birth. The new mother with postpartum psychosis is seriously agitated, unable to </span><a href="http://apahealthyminds.blogspot.com/2013/09/need-to-relax-how-meditation-can-help.html" style="font-family: inherit;" target="_blank">relax</a><span style="font-family: inherit;">. She is haunted by irrational ideas about herself and the baby--ideas, for example, that God wants her to send the baby to heaven or that the baby is a devil of some kind---and sometimes by irresistible urges to harm the baby. Postpartum psychosis is rare; it occurs after </span><i style="font-family: inherit;">far</i><span style="font-family: inherit;"> fewer than 1% of births. </span><b style="font-family: inherit;">It is a medical <i>emergency</i></b><span style="font-family: inherit;">.&nbsp;</span><br />
<b style="font-family: inherit;"><br /></b>
<b style="font-family: inherit;">When postpartum psychosis is suspected, the new mother must be seen immediately by a physician, preferably a<a href="http://apahealthyminds.blogspot.com/2013/03/what-to-expect-for-your-first-visit_21.html" target="_blank"> psychiatrist</a>.&nbsp;</b><br />
<a href="http://1.bp.blogspot.com/-z3iLnaLa_lI/UlMbuBUkflI/AAAAAAAAAtk/b_p-nlagguM/s1600/Cover+African+American+Family.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" src="http://1.bp.blogspot.com/-z3iLnaLa_lI/UlMbuBUkflI/AAAAAAAAAtk/b_p-nlagguM/s320/Cover+African+American+Family.jpg" width="213" /></a><span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;">Postpartum depression seems to be caused by a combination of genetics, the abrupt changes in hormones after birth, physical exhaustion, and the strain of adapting to a new role and the reactions and demands of friends and family. Postpartum depression is often a continuation of depression that was present, but not recognized, during pregnancy. In our society, we take it for granted that we shower medical and social attention on the pregnant woman---frequent visits to the obstetrician, baby showers---when all she has to do for the baby is to take good care of herself.&nbsp;</span><br />
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<span style="font-family: inherit;">After her baby is born---when she is exhausted from labor and delivery and when she has responsibility for the 24/7 care of a helpless infant--all that attention falls away. She may live far away from supportive family members. She may either have to go back to work before she is ready, or may feel isolated, away from the familiar duties and social contacts of the workplace. Usually there are no postpartum visits from nurses, and quality childcare is expensive and hard to find. Postpartum depression, although it occurs <i>everywhere</i> in the world, may be more common in our country for those reasons (occurs in about 15% of U.S. births).&nbsp;</span><br />
<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;">Postpartum depression can be successfully treated with psychotherapy and/or medication. Group therapy reassures the new mother that she's not alone and others are going through same issues. <a href="http://apahealthyminds.blogspot.com/2010/07/i-dont-know-how-to-help-them-tips-for.html" target="_blank">Family and friends</a> can play <b><i>major</i></b> roles in the new mother's recovery. <b>They should remind her that she is not responsible for her depression, and she can recover from it.&nbsp;</b></span><br />
<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;"> Helping with her baby can be useful, but it's <i>not </i>a good idea to take over baby care <i>completely</i>; that will just make her feel more inadequate.&nbsp;</span><br />
<span style="font-family: inherit;"><b><br /></b></span>
<span style="font-family: inherit;"><b>It's better to take care of the mother herself.</b>&nbsp;Offer simple diversions, like an outing, but without expecting them to treat depression. We don't want to make her feel unappreciative. <i>Sympathize</i> with her grief over missing the joys of new motherhood. Remind her of all the lovely things she planned and did for the baby before it was born, and point out what a good mother she is working to be.&nbsp;</span><br />
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<span style="font-family: inherit;"><b>Depression makes people feel helpless and hopeless</b>, so she may need encouragement to get the <a href="http://www.psychiatry.org/mental-health/more-topics/what-is-a-psychiatrist" target="_blank">professional</a> care she needs. Friends and family can help by contacting her family physician or obstetrician and by <a href="http://www.psychiatry.org/mental-health/key-topics/finding-help" target="_blank">locating a mental health professional</a> available to treat the new mother. With proper care, she will probably start to feel better within a few weeks.</span></div>
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</script>American Psychiatric Association noreply@blogger.com0tag:blogger.com,1999:blog-4119237672383930848.post-60152132063670710372013-09-03T17:54:00.000-04:002013-09-03T17:56:18.047-04:00Need to relax? How meditation can help you stay calm <div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: inherit;">By&nbsp;<a href="http://zenpsychiatry.com/" target="_blank">ElanaMiller, M.D.</a>,&nbsp;Resident Psychiatrist, UCLA Follow&nbsp;<a href="https://twitter.com/ElanaMD" target="_blank">@ElanaMD</a>&nbsp;</span></div>
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<span style="font-family: inherit;"><span style="line-height: 107%;"><a href="http://www.psychiatry.org/mental-health/healthy-minds-blog-contributors" target="_blank">Arshya Vahabzadeh, M.D.</a>,&nbsp;</span><span style="line-height: 107%;">Resident Psychiatrist, Harvard University/Mass.General/McLean</span></span></div>
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<span style="font-family: inherit;"><span style="line-height: 107%;">Follow&nbsp;<a href="https://twitter.com/VahabzadehMD" target="_blank">@VahabzadehMD</a></span><span style="line-height: 107%;"><o:p></o:p></span></span></div>
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<span style="line-height: 107%;"><span style="font-family: inherit;"><br /></span></span></div>
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<a href="http://4.bp.blogspot.com/-L2uUM4hWzyE/UiZZKQ73nCI/AAAAAAAAAsU/D6YkxdV_dMc/s1600/Elana+Miller+M.D..jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="http://4.bp.blogspot.com/-L2uUM4hWzyE/UiZZKQ73nCI/AAAAAAAAAsU/D6YkxdV_dMc/s200/Elana+Miller+M.D..jpg" width="154" /></a><span style="font-family: inherit;"><span style="line-height: 107%;">For many of us, daily
life doesn't lend itself well to relaxation and reflection. We find ourselves
running around from task to task. We wake up hurriedly, rush to <a href="http://www.workplacementalhealth.org/Publications-Surveys/Study-Examines-Employer-Perceptions-of-Stress-and-Resilience-Intervention.aspx" target="_blank">work</a>, get
bombarded with calls and emails throughout the day, speed through meals, try to
fit in a <a href="http://apahealthyminds.blogspot.com/2011/03/why-women-must-exercise-for-mental.html" target="_blank">workout</a>, and schedule time with friends / spouses / kids. . . which leaves us with little to zero time for ourselves.&nbsp;</span></span><span style="font-family: inherit; line-height: 107%;">It's a tough way to live, day in and day out.
Meditation is one tool we can use to find some calm.</span></div>
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<a href="http://3.bp.blogspot.com/-faCdhIwDwkM/UiZZLmuI5MI/AAAAAAAAAsc/RjZbVCZZnYA/s1600/Dr+V+headshot+2.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="http://3.bp.blogspot.com/-faCdhIwDwkM/UiZZLmuI5MI/AAAAAAAAAsc/RjZbVCZZnYA/s200/Dr+V+headshot+2.jpg" width="168" /></a><span style="font-family: inherit;"></span></div>
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<span style="font-family: inherit;"><span style="font-family: inherit;"><br /></span></span></div>
<span style="font-family: inherit;">Put simply, meditation
is the practice of focused, <a href="http://apahealthyminds.blogspot.com/search/label/mindfulness" target="_blank">mindful</a> attention. One starts focusing on the
breath, following the breath in and out. Inevitably, we get distracted, and our
mind wanders: <i>Did I feed the dog? That was so annoying what Bill did at
work today. Oh, I'm getting distracted, I'm so bad at meditating!&nbsp;</i><o:p></o:p></span><br />
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<span style="font-family: inherit;">This is okay - and even expected. When the mind wanders we simply <i>bring the focus back to the breath</i>. When a very strong emotion of physical sensation calls our attention
away, we can make that sensation the new object of meditation, watching as it
gets stronger or weaker. When the sensation isn't so strong anymore, we <i>return
to the breath.&nbsp;</i>Training the mind is like training a puppy - when it runs
away, we bring it back, over and over.<o:p></o:p></span></div>
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<span style="font-family: inherit;">So how does this simple
practice help cultivate relaxation in daily life?<o:p></o:p></span></div>
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<span style="font-family: inherit;"><b>1. Meditation helps you stay in the present</b><b><o:p></o:p></b></span></div>
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<span style="font-family: inherit;">So much of our time is
spent in the past and the future that we rarely are <i>present in the moment.&nbsp;</i>We
spend so much time remembering, regretting, planning, and worrying that we miss
the moments of joy and spontaneity that are right in front of us.<o:p></o:p></span></div>
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<span style="font-family: inherit;">Meditation helps train
the mind to focus on the present moment. Instead of regretting things we can't
change, or worrying about bad things that haven't even happened yet, we can
learn to accept <i>and</i> appreciate our current circumstances.<o:p></o:p></span></div>
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<span style="font-family: inherit;"><b>2. Meditation teaches you how to redirect your mind</b><b><o:p></o:p></b></span></div>
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<span style="font-family: inherit;">Sometimes we get caught
up thinking (obsessing!) about a big problem, and we have the idea that if we just think
hard enough we can solve it - but that's rarely the case. The best insights
usually come in those "in between" moments - in the shower, when
you're driving, when you're enjoying a cup of tea.<o:p></o:p></span></div>
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<span style="font-family: inherit;">But even if we're aware
that worrying and ruminating won't solve our problems, we don't know how to
shut our minds off. Meditation can teach you this skill! Like any skill, it
requires practice. But with dedicated practice, even five or ten minutes a day,
we can learn how to let go of worries and redirect our mind to the present
moment.<o:p></o:p></span></div>
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<b>3.</b> <b>Meditation teaches you to be more aware of your thoughts and
emotions</b><o:p></o:p></span></div>
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<span style="font-family: inherit;">Too often we have a
thought and react to it without considering why. We get angry at someone and
start yelling. We hear a critical remark and get defensive. Instead of taking
our thoughts and assumptions as facts and immediately reacting (possibly saying
or doing something we'd regret), we can pause and consider what's really going
on.&nbsp;<o:p></o:p></span></div>
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<span style="font-family: inherit;">Maybe we feel angry but
are really hurt. Maybe we feel defensive because part of what the other person
said is true. Meditation teaches us to be more aware of our deepest
thoughts and emotions, so that we can <i>choose</i> to react to conflict in a wise
way.<o:p></o:p></span></div>
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<span style="font-family: inherit;"><b>4. Meditation helps you tolerate difficult emotions</b><b><o:p></o:p></b></span></div>
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<span style="font-family: inherit;">Some people have a
misunderstanding that meditation somehow helps you get rid of all negative
emotions - after all, isn't that what enlightenment is?<o:p></o:p></span></div>
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<span style="font-family: inherit;">The truth is, though,
that painful emotions like sadness, anger, and shame are part of being human. We
make things worse when we fight against these emotions or blame ourselves for
having them.<o:p></o:p></span></div>
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<span style="font-family: inherit;">Instead of getting
caught up in the narratives of our emotions, we can learn to experience them
just as they are. Anger can feel like a tightness and burning of the chest.
Shame can be a flushed feeling of the face and churning feeling in the stomach. Meditation teaches us to experience these emotions without getting caught
up in the story.<o:p></o:p></span></div>
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<span style="font-family: inherit;"><b>Does Meditation really
work? What are the basic elements?</b><o:p></o:p></span></div>
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<a href="http://4.bp.blogspot.com/-B6GB_WP7oNI/UiZZnHJVPTI/AAAAAAAAAsk/5PuAavSy8_Y/s1600/yoga.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="212" src="http://4.bp.blogspot.com/-B6GB_WP7oNI/UiZZnHJVPTI/AAAAAAAAAsk/5PuAavSy8_Y/s320/yoga.jpg" style="cursor: move;" width="320" /></a><span style="font-family: inherit;">According to a
government survey, almost 1 in 10 adults use meditation each year to help them
cope with conditions such as <a href="http://www.psychiatry.org/anxiety-disorders" target="_blank">anxiety</a>, <a href="http://www.psychiatry.org/mental-health/key-topics/depression" target="_blank">depression</a>, pain, stress, <a href="http://apahealthyminds.blogspot.com/2012/11/sleep-hygiene-5-practical-tips-for-more.html" target="_blank">insomnia</a>, and
symptoms associated with chronic illness. It is believed that meditation can
improve the ability to focus attention and improve how we handle our emotions.
These improvements may have broader benefits for our daily lives including
personal relationships.<o:p></o:p></span></div>
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<span style="font-family: inherit;">Researchers have linked
meditation to some beneficial changes in the human body. Some experts have
suggested that meditation may dampen down our body’s sympathetic nervous
system, the system responsible for our “fight or flight” response. There is
also continuing interest on how meditation can alter different parts of the
brain, although the answer remains unclear and research is ongoing.<o:p></o:p></span></div>
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<span style="font-family: inherit;">The&nbsp;</span><a href="http://nccam.nih.gov/" target="_blank">National Center for Complementary and Alternative Medicine</a>, a federally funded research organization, suggests that there are several elements that are important when you are trying any type of meditation. These elements include finding a quiet location, a comfortable posture, being able to focus your attention, and having an open attitude to the experience.</div>
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<b style="font-family: inherit;">Interested in learning
more about how meditation can help you lead a happier and more relaxed life?</b></div>
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<span style="font-family: inherit;">Check out <span style="color: #1155cc;"><a href="http://zenpsychiatry.com/">zenpsychiatry.com</a>&nbsp;</span></span><span style="font-family: inherit;">where Elana Miller, M.D., blogs about
integrative strategies to be happy, live well, and fulfill your greatest
potential. To get tips and helpful advice sent straight to your inbox, sign up
for her </span><span style="color: #1155cc; font-family: inherit;"><a href="http://zenpsychiatry.com/newsletter/" target="_blank">free newsletter</a></span><span style="font-family: inherit;">.</span></div>
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</script> American Psychiatric Association noreply@blogger.com0